Literature DB >> 35304038

Feasibility of a geriatric comanagement (GERICO) pilot program for patients 75 and older undergoing radical cystectomy.

Allison S Letica-Kriegel1, Amy L Tin2, Garrett M Nash1, Nicole E Benfante3, Nita McNeil1, Andrew J Vickers2, Bernard Bochner3, Sherri M Donat3, Alvin Goh3, Guido Dalbagni3, Timothy Donahue3, Eugene K Cha3, Eugene Pietzak3, Harry Herr3, Beatriz Korc-Grodzicki4, Armin Shahrokni5.   

Abstract

BACKGROUND: Retrospective studies have shown the beneficial impact of geriatric comanagement (GERICO) on perioperative outcomes of older adults with cancer. We prospectively assessed the feasibility of perioperative GERICO for older adults with bladder cancer undergoing radical cystectomy.
METHODS: We conducted a pilot study wherein all patients 75 years and older undergoing radical cystectomy between October 2019 and November 2020 were referred to the Geriatric Service preoperatively. Feasibility was defined according to the percentage of patients who received preoperative evaluation by the Geriatrics Service, who were followed for more than 80% of their inpatient days and who had their surgery rescheduled for logistical reasons. Urology advanced practice provider (APP) satisfaction with the program was measured via an 11-item survey.
RESULTS: Sixty-six eligible patients underwent radical cystectomy in the stated time frame; 59 (89%; 95% confidence interval [CI], 79-97%) were referred to the Geriatric Service for evaluation. The median age of patients who had geriatric comanagement was 79 years; 40 (68%) were male. Forty-one patients (69%) were visited on at least 80% of the days in which they were not in the intensive care unit. No surgeries were rescheduled for logistical reasons. Nine of the 12 urology APPs (75%) responded to the survey; all nine "somewhat" or "strongly" agreed with statements indicating satisfaction with the program.
CONCLUSION: Despite the challenges of the COVID-19 pandemic, we showed that perioperative GERICO is feasible. Fully powered prospective randomized controlled trials should be conducted to assess GERICO's impact on perioperative outcomes of older adults with cancer.
Copyright © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Entities:  

Keywords:  Bladder cancer; Comanagement; Geriatric comanagement; Geriatrics; Radical cystectomy

Mesh:

Year:  2022        PMID: 35304038      PMCID: PMC9232991          DOI: 10.1016/j.ejso.2022.02.023

Source DB:  PubMed          Journal:  Eur J Surg Oncol        ISSN: 0748-7983            Impact factor:   4.037


  26 in total

Review 1.  The Role of Advanced Practice Providers in Urology.

Authors:  Deepak A Kapoor
Journal:  Urol Clin North Am       Date:  2021-03-12       Impact factor: 2.241

2.  Development of a Geriatric Service in a Cancer Center: Lessons Learned.

Authors:  Beatriz Korc-Grodzicki; William Tew; Arti Hurria; Heidi Yulico; Stuart Lichtman; Paul Hamlin; George Bosl
Journal:  J Oncol Pract       Date:  2017-02       Impact factor: 3.840

3.  Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology.

Authors:  Ahmad Shabsigh; Ruslan Korets; Kinjal C Vora; Christine M Brooks; Angel M Cronin; Caroline Savage; Ganesh Raj; Bernard H Bochner; Guido Dalbagni; Harry W Herr; S Machele Donat
Journal:  Eur Urol       Date:  2008-07-18       Impact factor: 20.096

4.  Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes.

Authors:  Susan M Friedman; Daniel A Mendelson; Karilee W Bingham; Stephen L Kates
Journal:  Arch Intern Med       Date:  2009-10-12

5.  Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population.

Authors:  Susan M Friedman; Daniel A Mendelson; Stephen L Kates; Robert M McCann
Journal:  J Am Geriatr Soc       Date:  2008-05-22       Impact factor: 5.562

6.  Outcomes Associated With Delirium in Older Patients in Surgical ICUs.

Authors:  Michele C Balas; Mary Beth Happ; Wei Yang; Lakshmipathi Chelluri; Therese Richmond
Journal:  Chest       Date:  2008-11-18       Impact factor: 9.410

7.  Preoperative frailty and outcome in patients undergoing radical cystectomy.

Authors:  Ellen van der Vlies; Maartje Los; Pascal E F Stijns; Marike van Hengel; Nynke M S Blaauw; Willem Jan W Bos; Eric P A van Dongen; Harm H E van Melick; Peter G Noordzij
Journal:  BJU Int       Date:  2020-08-04       Impact factor: 5.588

8.  Geriatric comanagement reduces perioperative complications and shortens duration of hospital stay after lumbar spine surgery: a prospective single-institution experience.

Authors:  Owoicho Adogwa; Aladine A Elsamadicy; Victoria D Vuong; Jessica Moreno; Joseph Cheng; Isaac O Karikari; Carlos A Bagley
Journal:  J Neurosurg Spine       Date:  2017-09-29

9.  A Simplified Frailty Index to Predict Outcomes After Radical Cystectomy.

Authors:  Niranjan J Sathianathen; Stephanie Jarosek; Nathan Lawrentschuk; Damien Bolton; Badrinath R Konety
Journal:  Eur Urol Focus       Date:  2018-01-20

10.  Electronic Rapid Fitness Assessment Identifies Factors Associated with Adverse Early Postoperative Outcomes following Radical Cystectomy.

Authors:  Gregory T Chesnut; Amy L Tin; Daniel D Sjoberg; Brian Jang; Nicole Benfante; Saman Sarraf; Harry Herr; S Machele Donat; Guido Dalbagni; Bernard Bochner; Armin Shahrokni; Alvin C Goh
Journal:  J Urol       Date:  2020-09-08       Impact factor: 7.450

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