Frail Elderly Syndrome
Conditions
Keywords
frail patient, general anaesthesia, regional anaesthesia
Brief summary
The aim of this study is to comparatively evaluate the effects of different anaesthesia methods (spinal anaesthesia and general anaesthesia) administered to frail elderly patients scheduled for transurethral surgery (e.g. TUR-Prostate or TUR-Bladder) on postoperative morbidity and mortality rates.
Detailed description
When planning transurethral surgery in frail patients, optimising the anaesthesia method is critical in minimising perioperative risks. In a 2021 study by Darwish et al. (1), 28,486 TUR-P cases were grouped according to the selected anaesthesia method. The 30-day mortality rate was 0.4% in the neuroaxial anaesthesia (spinal/epidural) group and 0.7% in the general anaesthesia group; the neuroaxial anaesthesia group showed significantly better outcomes in terms of secondary morbidity rates such as mortality and sepsis. However, there are studies in the literature supporting general anaesthesia. A study by Ayoub et al. (4) emphasised that in frail patients, similar morbidity rates can be achieved with general anaesthesia or spinal anaesthesia; spinal anaesthesia may increase the risk of hypotension and bradycardia. Based on these studies, the selection of the appropriate anaesthesia method for transurethral procedures is of critical importance in terms of patient morbidity and mortality rates. This study aims to contribute to clinical guidelines by clarifying which type of anaesthesia is safer in this specific demographic and clinical group. Within the scope of the research, parameters such as complications associated with the anaesthesia method, length of hospital stay, readmission rate, and 30-day mortality are analysed with the aim of determining the most appropriate and safest anaesthesia method for the vulnerable patient group.
Interventions
PROCEDUREgeneral anaesthesia
Patients undergoing general anaesthesia
PROCEDUREregional anaesthesia
Patients undergoing regional anaesthesia
Sponsors
Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Elderly patients aged 65 and over * ASA (American Society of Anaesthesiologists) physical condition classification I-III patients * meeting the criteria for frailty
Exclusion criteria
* Non-elective emergency surgeries * Patients under 65 years of age * Patients classified as ASA Class IV * Patients unable to provide informed consent due to cognitive impairment * Patients who have previously undergone major neurological or cardiac surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative morbidity | 30-day postoperative morbidity | Morbidity rates up to the 30th day postoperatively will be recorded. Patients will be contacted by phone and the data will be recorded. |
| Postoperative mortality | 30-day postoperative mortality | Mortality rates up to the 30th day postoperatively will be recorded. Patients will be contacted by phone and the data will be recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| intraoperative complications, | perioperative period | In the study, complications that develop during surgery (arrhythmia etc.), whether the surgical time differs between the two groups, and the length of hospital stay will be recorded. |
| Duration of surgery | Until the end of the surgery | The surgical durations of patients in both groups will be recorded in the study. |
| Length of hospital stay | first week after surgery | The length of time the patient stays in hospital for the operation will be recorded. |
Contacts
Primary ContactDilek MD Metin Yamac
Backup ContactDilek M Yamac
Outcome results
None listed