Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial
Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial
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DOI：
10.1371/journal.pone.0064834
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发表时间：
2013-06-19
期刊：
影响因子：
3.7
通讯作者：
van Leeuwen, Barbara L.
中科院分区：
文献类型：
--
作者：
Hempenius, Liesbeth;Slaets, Joris P. J.;van Leeuwen, Barbara L.
背景：谵妄是一种严重而常见的术后并发症，尤其是在年老体弱的患者中。本研究的目的是评估老年联络干预的效果与标准护理的发病率术后谵妄在体弱的老年癌症患者进行了择期手术治疗的实体瘤。方法：患者年龄超过65岁，谁正在接受择期手术的实体瘤被招募到一个多中心，前瞻性，随机，对照试验。患者被随机分为标准治疗组和老年联络干预组。干预措施包括术前老年咨询，针对谵妄危险因素的个人治疗计划，住院期间由老年护士每天进行访问，并就管理遇到的任何问题提出建议。主要结局是术后谵妄的发生率。次要结局指标是谵妄的严重程度，住院时间，并发症，死亡率，护理依赖性，生活质量，恢复到一个独立的术前生活状况和额外的护理在home.Results：在总的，260例患者的数据进行了分析。31例患者出现谵妄（11.9%），干预组与常规护理组谵妄发生率无显著性差异（9.4% vs. 14.3%，OR：0.63，95% CI：0.29-1.35）。在这项研究中，一项基于虚弱的老年联络干预，用于预防接受择期手术的虚弱老年癌症患者术后谵妄，实体瘤还没有被证明是有效的。
Background: Delirium is a serious and common postoperative complication, especially in frail elderly patients. The aim of this study was to evaluate the effect of a geriatric liaison intervention in comparison with standard care on the incidence of postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour.Methods: Patients over 65 years of age who were undergoing elective surgery for a solid tumour were recruited to a multicentre, prospective, randomized, controlled trial. The patients were randomized to standard treatment versus a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium, daily visits by a geriatric nurse during the hospital stay and advice on managing any problems encountered. The primary outcome was the incidence of postoperative delirium. The secondary outcome measures were the severity of delirium, length of hospital stay, complications, mortality, care dependency, quality of life, return to an independent preoperative living situation and additional care at home.Results: In total, the data of 260 patients were analysed. Delirium occurred in 31 patients (11.9%), and there was no significant difference between the incidence of delirium in the intervention group and the usual-care group (9.4% vs. 14.3%, OR: 0.63, 95% CI: 0.29-1.35).Conclusions: Within this study, a geriatric liaison intervention based on frailty for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour has not proven to be effective.