A description of interventions prompted by preoperative comprehensive geriatric assessment and optimization in older elective noncardiac surgical patients
Moppett, Ian K.
Moppett, Ian K.
Abstract
OBJECTIVES: Comprehensive Geriatric Assessment (CGA), a multicomponent, complex intervention, can be used to improve perioperative outcomes. This study aimed to describe the actions and interventions prompted by preoperative CGA and optimization in elective noncardiac, older, surgical patients. DESIGN: Retrospective observational study. SETTING AND PARTICIPANTS: Five hundred consecutive patients aged over 65 years attending a preoperative CGA and optimization clinic in a single academic center. METHODS: A retrospective review of electronic clinical records was undertaken. CGA prompted actions and interventions were categorized a priori and examined according to the perioperative pathway and frailty status. RESULTS: Patients received a median of nine interventions (IQR 6-12, range 0-28). Long-term condition medication changes were made in 375 (75.0%) patients, lifestyle advice provided in 269 (53.8%), therapy interventions delivered in 117 (23.4%), shared decision making documented in 495 (99.0%) with individualized admission plans documented in 410/426 (96.2%). Following CGA, 74/500 (14.8%) patients did not undergo surgery and were more likely to have benign pathology (69% vs 53%, P = .01), higher frailty scores (Edmonton Frail Scale 8 (IQR 5-10) vs 4 (IQR 2-6), P Copyright © 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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Date
2022
Type
Article
Subject
Comprehensive geriatric assessment, HCOP, Retrospective study
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Citation
Shahab, R., Lochrie, N., Moppett, I.K., Dasgupta, P., Partridge, J.S.L. and Dhesi, J.K. (2022) 'A description of interventions prompted by preoperative comprehensive geriatric assessment and optimization in older elective noncardiac surgical patients', Journal of the American Medical Directors Association, 23(12), pp. 1948-1954.e4. doi: 10.1016/j.jamda.2022.08.009.