Literature DB >> 33407187

Protocol for evaluation of perioperative risk in patients aged over 75 years: Aged Patient Perioperative Longitudinal Evaluation-Multidisciplinary Trial (APPLE-MDT study).

Yanhong Zhang1,2, Lina Ma3, Tianlong Wang4, Wei Xiao4, Shibao Lu5, Chao Kong5, Chaodong Wang2, Xiaoying Li1, Yun Li3, Chunlin Yin6, Suying Yan7, Ying Li8, Kun Yang9, Piu Chan10,11,12.   

Abstract

BACKGROUND: With the extended life expectancy of the Chinese population and improvements in surgery and anesthesia techniques, the number of aged patients undergoing surgery has been increasing annually. However, safety, effectiveness, and quality of life of aged patients undergoing surgery are facing major challenges. In order to standardize the perioperative assessment and procedures, we have developed a perioperative evaluation and auxiliary decision-making system named "Aged Patient Perioperative Longitudinal Evaluation-Multidisciplinary Trial (APPLE-MDT)".
METHODS: We will conduct a perioperative risk evaluation and targeted intervention, with follow-ups at 1, 3, and 6 months after surgery. The primary objective of the study is to evaluate the effectiveness of the "Aged Patient Perioperative Longitudinal Evaluation-Multiple Disciplinary Trial Path" (hereinafter referred to as the APPLE-MDT path) in surgical decision-making for aged patients (≥75 years) undergoing elective surgery under non-local anesthesia in the operating room. The secondary objectives of the study are to evaluate the postoperative outcome and health economics of the APPLE-MDT path applied to the surgical decision-making of aged patients (≥75 years) undergoing elective surgery under non-local anesthesia and to optimize intervention strategies for aged patients undergoing surgery to reduce the occurrence of postoperative complications and improve the quality of life after surgery. DISCUSSION: It is necessary to formulate a reliable, effective, and concise evaluation tool, which can effectively predict the perioperative complications and mortality of aged patients, support targeted intervention strategies, and allow for a more comprehensive risk and benefit analysis, thereby forming an effective senile perioperative surgery management path. It is expected that the implementation of this protocol can reduce the occurrence of postoperative complications, improve the postoperative quality of life, shorten hospital stay, reduce hospitalization expenses, reduce social burden, and allow the elderly to have a good quality of life after surgery. TRIAL REGISTRATION: ChiCTR, ChiCTR1800020363 , Registered 15 December 2018.

Entities:  

Keywords:  Advanced-age patients; Age-related surgical risk factors; Multidisciplinary evaluation; Perioperative assessment

Mesh:

Year:  2021        PMID: 33407187      PMCID: PMC7788705          DOI: 10.1186/s12877-020-01956-3

Source DB:  PubMed          Journal:  BMC Geriatr        ISSN: 1471-2318            Impact factor:   3.921


  30 in total

1.  Proactive care of older people undergoing surgery ('POPS'): designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients.

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Journal:  Age Ageing       Date:  2007-01-27       Impact factor: 10.668

2.  Where are we in perioperative medicine for older surgical patients? A UK survey of geriatric medicine delivered services in surgery.

Authors:  Judith S L Partridge; Geraint Collingridge; Adam Lee Gordon; Finbarr C Martin; Danielle Harari; Jugdeep K Dhesi
Journal:  Age Ageing       Date:  2014-08-04       Impact factor: 10.668

3.  Progress in development of the index of ADL.

Authors:  S Katz; T D Downs; H R Cash; R C Grotz
Journal:  Gerontologist       Date:  1970

4.  The aging process.

Authors:  Joseph A Troncale
Journal:  Postgrad Med       Date:  1996-05       Impact factor: 3.840

5.  Predicting adverse postoperative outcomes in patients aged 80 years or older.

Authors:  L L Liu; J M Leung
Journal:  J Am Geriatr Soc       Date:  2000-04       Impact factor: 5.562

6.  Does comprehensive geriatric assessment improve the estimate of surgical risk in elderly patients? An Italian multicenter observational study.

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Journal:  Am J Surg       Date:  2015-06-04       Impact factor: 2.565

7.  Surgical outcomes for patients aged 80 and older: morbidity and mortality from major noncardiac surgery.

Authors:  Mary Beth Hamel; William G Henderson; Shukri F Khuri; Jennifer Daley
Journal:  J Am Geriatr Soc       Date:  2005-03       Impact factor: 5.562

8.  A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans.

Authors:  J E Morley; T K Malmstrom; D K Miller
Journal:  J Nutr Health Aging       Date:  2012-07       Impact factor: 4.075

9.  New assessment for advanced age: Italian study protocol on the assessment of surgical risk in the over-75-year age-group.

Authors:  Annarita Pilleri; Giampaolo Scorcu
Journal:  Monaldi Arch Chest Dis       Date:  2017-07-18

Review 10.  European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium.

Authors:  César Aldecoa; Gabriella Bettelli; Federico Bilotta; Robert D Sanders; Riccardo Audisio; Anastasia Borozdina; Antonio Cherubini; Christina Jones; Henrik Kehlet; Alasdair MacLullich; Finn Radtke; Florian Riese; Arjen J C Slooter; Francis Veyckemans; Sylvia Kramer; Bruno Neuner; Bjoern Weiss; Claudia D Spies
Journal:  Eur J Anaesthesiol       Date:  2017-04       Impact factor: 4.330

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Journal:  BMC Geriatr       Date:  2022-08-04       Impact factor: 4.070

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