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Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients.
PLoS One 2016; 11(2):e0143364Plos

Abstract

BACKGROUND

The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.

METHODS

A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL) functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.

RESULTS

Data of 260 patients (intervention n = 127, Control n = 133) were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88), an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87) and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49).

CONCLUSIONS

A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.

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.University Center for Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.Department of Geriatrics, Radboud University Medical Center, Nijmegen, the Netherlands.Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Pub Type(s)

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

Language

eng

PubMed ID

26901417

Citation

Hempenius, Liesbeth, et al. "Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients." PloS One, vol. 11, no. 2, 2016, pp. e0143364.
Hempenius L, Slaets JP, van Asselt D, et al. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients. PLoS ONE. 2016;11(2):e0143364.
Hempenius, L., Slaets, J. P., van Asselt, D., de Bock, T. H., Wiggers, T., & van Leeuwen, B. L. (2016). Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients. PloS One, 11(2), pp. e0143364. doi:10.1371/journal.pone.0143364.
Hempenius L, et al. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients. PLoS ONE. 2016;11(2):e0143364. PubMed PMID: 26901417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients. AU - Hempenius,Liesbeth, AU - Slaets,Joris P J, AU - van Asselt,Dieneke, AU - de Bock,Truuske H, AU - Wiggers,Theo, AU - van Leeuwen,Barbara L, Y1 - 2016/02/22/ PY - 2014/07/19/received PY - 2015/10/31/accepted PY - 2016/2/23/entrez PY - 2016/2/24/pubmed PY - 2016/7/19/medline SP - e0143364 EP - e0143364 JF - PloS one JO - PLoS ONE VL - 11 IS - 2 N2 - BACKGROUND: The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined. METHODS: A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL) functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life. RESULTS: Data of 260 patients (intervention n = 127, Control n = 133) were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88), an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87) and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49). CONCLUSIONS: A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed. TRIAL REGISTRATION: Nederlands Trial Register, Trial ID NTR 823. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26901417/Long_Term_Outcomes_of_a_Geriatric_Liaison_Intervention_in_Frail_Elderly_Cancer_Patients_ L2 - http://dx.plos.org/10.1371/journal.pone.0143364 DB - PRIME DP - Unbound Medicine ER -