General Surgery
Conditions
Keywords
Senior, Elderly, Acute Care, Emergency Surgery
Brief summary
The aim of this study is to examine the impact implementing an elder-friendly surgical unit has on post-operative complications, mortality and quality of life for patients ≥ 65 years old who have undergone emergency surgical care.
Detailed description
The investigators hypothesize that the elder-friendly surgical unit will reduce in-hospital complications and mortality in a cost-effective manner, for this at risk population. Specific elder-friendly interventions include: 1. Locate all elderly surgical patients on one nursing unit 2. Interdisciplinary team-based care 3. Elder-friendly evidence-informed practices including: comfort rounds with early mobilization, delirium prevention/management, optimal nutrition and prevention of post-operative complications 4. Early and interdisciplinary discharge management This is a prospective, before-after study with a concurrent control group. Four senior patient groups will be followed:
Interventions
OTHERElder-Friendly Surgical Unit
Sponsors
Alberta Innovates Health Solutions
University of Alberta
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients \> 65 years old admitted for Acute care and Emergency Surgery * Received acute abdominal surgery
Exclusion criteria
* Elective general surgery cases * Nursing home resident requiring full nursing care \[dependency in 3 or more activities of daily living \] * Palliative surgery \[surgery with the primary intention of improving quality of life or relieving symptoms caused by advancing non-curative disease\] * Multi-system trauma * Patients from out of province or transferred from another inpatient service or hospital
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-Operative complications | During initial in-hospital stay (0-12 weeks on average) | Includes a) intensive care unit admission (includes respiratory failure, cardiac arrest or septic shock), b) vascular complications (myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism), c) serious infections (pneumonia, intra-abdominal abscess, urinary tract infection, deep wound infection or infected decubitus ulcer) or d) protracted delirium (≥48 hours) |
| Death | During initial in-hospital stay (0-12 weeks on average) | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-discharge complications or health-events requiring re-admission | Within 30 days post-discharge | — |
| Cost per quality-adjusted life year | 6 months post-discharge | Both direct and indirect study participant costs |
Other
| Measure | Time frame | Description |
|---|---|---|
| Health Related Quality of Life | 6 weeks and 6 months post-discharge | Including: EQ-5D questionnaire, SF-12 Questionnaire |
| Functional Status (Frailty) | 6 weeks post-discharge | Including: Edmonton Frail Scale, and Timed Up-and-Go Test |
Countries
Canada
Outcome results
None listed