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Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial.
PLoS One 2013; 8(6):e64834Plos

Abstract

BACKGROUND

Delirium is a serious and common postoperative complication, especially in frail elderly patients. The aim of this study was to evaluate the effect of a geriatric liaison intervention in comparison with standard care on the incidence of postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour.

METHODS

Patients over 65 years of age who were undergoing elective surgery for a solid tumour were recruited to a multicentre, prospective, randomized, controlled trial. The patients were randomized to standard treatment versus a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium, daily visits by a geriatric nurse during the hospital stay and advice on managing any problems encountered. The primary outcome was the incidence of postoperative delirium. The secondary outcome measures were the severity of delirium, length of hospital stay, complications, mortality, care dependency, quality of life, return to an independent preoperative living situation and additional care at home.

RESULTS

In total, the data of 260 patients were analysed. Delirium occurred in 31 patients (11.9%), and there was no significant difference between the incidence of delirium in the intervention group and the usual-care group (9.4% vs. 14.3%, OR: 0.63, 95% CI: 0.29-1.35).

CONCLUSIONS

Within this study, a geriatric liaison intervention based on frailty for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour has not proven to be effective.

TRIAL REGISTRATION

Nederlands Trial Register Trial ID NTR 823.

Authors+Show Affiliations

University Center for Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands ; Geriatric Center, Medical Center Leeuwarden, Leeuwarden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23840308

Citation

Hempenius, Liesbeth, et al. "Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report On a Multicentre, Randomized, Controlled Trial." PloS One, vol. 8, no. 6, 2013, pp. e64834.
Hempenius L, Slaets JP, van Asselt D, et al. Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial. PLoS ONE. 2013;8(6):e64834.
Hempenius, L., Slaets, J. P., van Asselt, D., de Bock, G. H., Wiggers, T., & van Leeuwen, B. L. (2013). Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial. PloS One, 8(6), pp. e64834. doi:10.1371/journal.pone.0064834.
Hempenius L, et al. Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report On a Multicentre, Randomized, Controlled Trial. PLoS ONE. 2013;8(6):e64834. PubMed PMID: 23840308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial. AU - Hempenius,Liesbeth, AU - Slaets,Joris P J, AU - van Asselt,Dieneke, AU - de Bock,Geertruida H, AU - Wiggers,Theo, AU - van Leeuwen,Barbara L, Y1 - 2013/06/19/ PY - 2012/10/19/received PY - 2013/04/16/accepted PY - 2013/7/11/entrez PY - 2013/7/11/pubmed PY - 2013/7/11/medline SP - e64834 EP - e64834 JF - PloS one JO - PLoS ONE VL - 8 IS - 6 N2 - BACKGROUND: Delirium is a serious and common postoperative complication, especially in frail elderly patients. The aim of this study was to evaluate the effect of a geriatric liaison intervention in comparison with standard care on the incidence of postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. METHODS: Patients over 65 years of age who were undergoing elective surgery for a solid tumour were recruited to a multicentre, prospective, randomized, controlled trial. The patients were randomized to standard treatment versus a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium, daily visits by a geriatric nurse during the hospital stay and advice on managing any problems encountered. The primary outcome was the incidence of postoperative delirium. The secondary outcome measures were the severity of delirium, length of hospital stay, complications, mortality, care dependency, quality of life, return to an independent preoperative living situation and additional care at home. RESULTS: In total, the data of 260 patients were analysed. Delirium occurred in 31 patients (11.9%), and there was no significant difference between the incidence of delirium in the intervention group and the usual-care group (9.4% vs. 14.3%, OR: 0.63, 95% CI: 0.29-1.35). CONCLUSIONS: Within this study, a geriatric liaison intervention based on frailty for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour has not proven to be effective. TRIAL REGISTRATION: Nederlands Trial Register Trial ID NTR 823. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/23840308/Outcomes_of_a_Geriatric_Liaison_Intervention_to_Prevent_the_Development_of_Postoperative_Delirium_in_Frail_Elderly_Cancer_Patients:_Report_on_a_Multicentre_Randomized_Controlled_Trial_ L2 - http://dx.plos.org/10.1371/journal.pone.0064834 DB - PRIME DP - Unbound Medicine ER -