None listed
Conditions
Brief summary
The objective of this study is to evaluate the effect of multi-domain tailored interventions administered through a POPS (Perioperative care of Older People undergoing Surgery) service among patients with varying degrees of frailty awaiting elective hip or knee arthroplasty on post-operative complications and length of stay. We aim to improve our understanding of how individual characteristics, frailty and comorbidities may have an impact on post-operative outcomes. We hypothesised that a geriatrican-led preoperative comprehensive geriatric assessment (CGA), combined with targeted interventions, along with 6 weeks centre-based exercise program as prehabilitation, would reduce post-operative complications and hence length of stay in older individuals undergoing elective arthroplasty surgery. This was retrospective observational study comparing a post intervention cohort with historic controls. Patients aged 65 years or older with a Clinical Frailty Scale (CFS) of 4 or greater, who were awaiting elective knee or hip replacement surgery were evaluated in our POPS @NALHN service between October 2018 to December 2019. Post-operative outcomes were compared with individuals who underwent joint replacement surgery between July 2017 to September 2018 without any pre-operative interventions.
Interventions
POPS (Perioperative care of Older People undergoing Surgery) service was established in our local hospital in October 2018. The aim of the service is to identify frail individuals awaiting hip and knee arthroplasty and provide tailored treatment derived from comprehensive geriatric assessment and a 6-weeks centre based exercise program as prehabilitation as standard of care. We aim to evaluate the effect of geriatrician-led comprehensive geriatric assessment and tailored exercise program on pos
POPS (Perioperative care of Older People undergoing Surgery) service was established in our local hospital in October 2018. The aim of the service is to identify frail individuals awaiting hip and knee arthroplasty and provide tailored treatment derived from comprehensive geriatric assessment and a 6-weeks centre based exercise program as prehabilitation as standard of care. We aim to evaluate the effect of geriatrician-led comprehensive geriatric assessment and tailored exercise program on post-operative outcomes and length of stay (LOS). The individuals were seen at our POPS @NALHN service between October 2018 to December 2019 Patient's case notes and electronic medical records were retrospectively accessed, with no patient contact involved. Records were accessed from the duration of their first clinic visit to up to 1 month post-hospital discharge. The primary outcome was post-operative length of stay following POPS service intervention. Secondary outcomes assessed were post-operative medical complications, surgical complications, discharge destination and readmissions within 30 days
Sponsors
Northern Adelaide Local health Network (NALHN) Department of Geriatrics Medicine
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria for both groups (intervention and control) included patients who patients who underwent elective total hip replacement (THR) or total knee replacement (TKR), with age 65 years and above and CFS of 4 or greater. Those who underwent upper limb arthroplasty or ankle arthroplasty were excluded.
Exclusion criteria
None
Outcome results
None listed