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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.



Autor: Liesbeth Hempenius , Joris P. J. Slaets, Dieneke van Asselt, Truuske H. de Bock, Theo Wiggers, Barbara L. van Leeuwen

Fuente: http://plos.srce.hr/



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