Geriatric Comanagement of Older Vascular Surgery Inpatients Reduces Hospital-Acquired Geriatric Syndromes

Thillainadesan, Janani; Aitken, Sarah; Monaro, Sue; Cullen, John; Kerdic, Richard; Hilmer, Sarah N.; Naganathan, Vasi

doi:10.1016/j.jamda.2021.09.037

Cited by 31 publications

(28 citation statements)

References 47 publications

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“…Previous studies showed that performing a preoperative CGA in patients ≥ 65 years undergoing vascular surgery is associated with a shorter LoS and a lower incidence of postoperative complications. 41 , 42 Based on the CGA, the geriatrician will, among other things, provide information to patient and family and define preventive measures for delirium and functional decline.…”

Section: Methodsmentioning

confidence: 99%

Multicomponent Prehabilitation as a Novel Strategy for Preventing Delirium in Older Chronic Limb Threatening Ischemia Patients: A Study Protocol

Meulenbroek¹,

Faes²,

Mil³

et al. 2022

CIA

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Objective Chronic limb threatening ischemia is the final stage of peripheral arterial disease. Current treatment is based on revascularization to preserve the leg. In the older, hospitalized chronic limb threatening ischemia patient, delirium is a frequent and severe complication after revascularization. Delirium leads to an increased length of hospital stay, a higher mortality rate and a decrease in quality of life. Currently, no specific guidelines to prevent delirium in chronic limb threatening ischemia patients exist. We aim to evaluate the effect of a multicomponent, multidisciplinary prehabilitation program on the incidence of delirium in chronic limb threatening ischemia patients ≥65 years. Design A prospective observational cohort study to investigate the effects of the program on the incidence of delirium will be performed in a large teaching hospital in the Netherlands. This manuscript describes the design of the study and the content of this specific prehabilitation program. Methods Chronic limb threatening ischemia patients ≥65 years that require revascularization will participate in the program. This program focuses on optimizing the patient’s overall health and includes delirium risk assessment, nutritional optimization, home-based physical therapy, iron infusion in case of anaemia and a comprehensive geriatric assessment in case of frailty. The primary outcome is the incidence of delirium. Secondary outcomes include quality of life, amputation-free survival, length of hospital stay and mortality. Exclusion criteria are the requirement of acute treatment or patients who are mentally incompetent to understand the procedures of the study or to complete questionnaires. A historical cohort from the same hospital is used as a control group. Discussion This study will clarify the effect of a prehabilitation program on delirium incidence in chronic limb threatening ischemia patients. New insights will be obtained on optimizing a patient’s preoperative mental and physical condition to prevent postoperative complications, including delirium. Trial This protocol is registered at the Netherlands National Trial Register (NTR) number: NL9380.

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Section: Methodsmentioning

confidence: 99%

Multicomponent Prehabilitation as a Novel Strategy for Preventing Delirium in Older Chronic Limb Threatening Ischemia Patients: A Study Protocol

Meulenbroek¹,

Faes²,

Mil³

et al. 2022

CIA

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“…1.1 | Dr Janani Thillainadesan (Clinical Research) 1 Why did you decide to embark upon a PhD? I thoroughly enjoyed the research experiences I had as a medical student doing an honours research year and as an Advanced Trainee (AT) in Geriatric Medicine.…”

Section: Geriatricians Who Are Recent Phd Graduatesmentioning

confidence: 99%

Why do a PhD? Tips and pitfalls

Thillainadesan

2022

Australas J Ageing

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“…The treatment priorities of patients can be overshadowed when mismatch occurs. There is increasing evidence that collaborative models of care between vascular surgeons and geriatricians can enhance shared decision-making and improve the care of older patients with vascular disease [ 5 ]. A more nuanced understanding of the progression of CLTI in patients of extreme older age can inform shared decision-making, and target treatment towards patient priorities.…”

mentioning

confidence: 99%

“…A comprehensive evaluation of surgical risk and anticipated outcomes is critically important to inform CLTI management for older patients. Whilst Comprehensive Geriatric Assessment improves surgical outcomes, it is time consuming and requires specialist geriatrician input [ 5 ]. A more accessible way to assess surgical risk in older patients is to use validated frailty assessment tools.…”

mentioning

confidence: 99%

Managing Chronic Limb‐Threatening Ischaemia in Patients at the Extremes of Older Age Requires a Patient‐Focused Approach

Cutmore

Aitken

2022

World j. surg.

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Geriatric Comanagement of Older Vascular Surgery Inpatients Reduces Hospital-Acquired Geriatric Syndromes

Cited by 31 publications

References 47 publications

Multicomponent Prehabilitation as a Novel Strategy for Preventing Delirium in Older Chronic Limb Threatening Ischemia Patients: A Study Protocol

Multicomponent Prehabilitation as a Novel Strategy for Preventing Delirium in Older Chronic Limb Threatening Ischemia Patients: A Study Protocol

Why do a PhD? Tips and pitfalls

Managing Chronic Limb‐Threatening Ischaemia in Patients at the Extremes of Older Age Requires a Patient‐Focused Approach

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