Improvement of Perioperative Care of Elderly Patients (PeriAge)

Universitätsklinikum Hamburg-Eppendorf

Status: Completed

Conditions: Perioperative Care

Treatments: Dietary Supplement: Dietary supplements; Behavioral: Systematic inclusion of family members; Device: Neurmonitoring; Procedure: Pain catheter; Procedure: Regional anesthesia; Device: Temperature management; Behavioral: Physical and breathing exercises; Other: Personal aids; Behavioral: Preoperative information; Other: Evaluation of long-term medication

Study type: Interventional

Funder types: Other

Identifiers

NCT03325413

PV5596

01VSF16057 (Other Grant/Funding Number)

Details and patient eligibility

About

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.

Full 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.

Enrollment: 310 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age >64 years
• Written informed patients consent
• forthcoming elective surgery
• Time interval from inclusion to appointed surgery at least 5 days

Exclusion criteria

• Refusal of consent
• Illiteracy
• Poor knowledge ofGerman language
• Mental disability
• Vision handicap (not corrected)
• Hearing handicap (not corrected)
• Benzodiazepine abuse
• Drug/ substance abuse
• Psychosis
• Parkinson disease
• Emergency surgery
• Planned postoperative ICU treatment
• Planned inpatient stay 1 night
• Cerebral surgery
• Ophthalmological surgery

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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310 participants in 3 patient groups

Control

No Intervention group

Description:

Usual care with assessment only (no study-related intervention)

Implementation

Other group

Description:

Implementation of intervention measures

Treatment:

Device: Temperature management

Behavioral: Physical and breathing exercises

Procedure: Pain catheter

Procedure: Regional anesthesia

Behavioral: Preoperative information

Other: Evaluation of long-term medication

Behavioral: Systematic inclusion of family members

Device: Neurmonitoring

Dietary Supplement: Dietary supplements

Other: Personal aids

Full-scale intervention

Other group

Treatment:

Device: Temperature management

Behavioral: Physical and breathing exercises

Procedure: Pain catheter

Procedure: Regional anesthesia

Behavioral: Preoperative information

Other: Evaluation of long-term medication

Behavioral: Systematic inclusion of family members

Device: Neurmonitoring

Dietary Supplement: Dietary supplements

Other: Personal aids