NCT03325413

Improvement of Perioperative Care of Elderly Patients

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 310 (actual)
• Sponsor: Universitätsklinikum Hamburg-Eppendorf · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

The focus of this study is the development of a perioperative treatment concept for elderly patients, based on individual necessities and risk factors, aiming to improve patient outcome. The planned interventions include preoperative screening for malnutrition, frailty and uncalled-for long-term medication, if required followed by early prophylaxis and treatment of these risk factors, prior to or during surgery.

Detailed description

In Germany every second inpatient surgical intervention is performed on patients aged 60 years and above. These patients often offer an extensive set of risk factors such as frailty, malnutrition, poor physical fitness and multi-morbidity that may in turn lead to longer hospitalizations and decline of health and functional status after surgery. An age-related increase in postoperative complications, such as postoperative cognitive dysfunction (POCD) and delirium is associated with a higher rate of postoperative morbidity, mortality and longer hospitalization. Early detection of risk factors and implementation of prophylactic measures is important to reduce postoperative complications and improve clinical outcomes in elderly patients. The aim of our study is to develop and verify a protocol - which allows for a systematic evaluation of risk factors and the implementation of prophylactic or therapeutic measures in order to optimize the postoperative outcome. The feasibility of our protocol will be verified in clinical practice by systematic process evaluations.

Conditions

• Perioperative Care

Interventions

Type	Name	Description
BEHAVIORAL	Systematic inclusion of family members	Systematic inclusion of family members/ reference person in the perioperative process
BEHAVIORAL	Preoperative information	Detailed preoperative information about delirium prevention and procedures
BEHAVIORAL	Physical and breathing exercises	Preoperative execution of physical and breathing exercises if necessary
DIETARY_SUPPLEMENT	Dietary supplements	Dietary supplements if necessary
OTHER	Evaluation of long-term medication	Avoidance of unsuitable drugs for elderly if possible
PROCEDURE	Regional anesthesia	Regional anesthesia whenever possible
OTHER	Personal aids	Personal orientation aids until anesthesia induction
DEVICE	Temperature management	Perioperative warming
DEVICE	Neurmonitoring	Using Bispectral index (BIS) to measure the depth of anesthesia
PROCEDURE	Pain catheter	A pain catheter will be used as postoperative pain therapy if possible

Timeline

• Start date: 2017-11-01
• Primary completion: 2020-05-14
• Completion: 2020-05-14
• First posted: 2017-10-30
• Last updated: 2021-05-18

Locations

1 site across 1 country: Germany