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| Name | Class |
|---|---|
| Alberta Innovates Health Solutions | OTHER |
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The aim of this study is to examine the impact implementing an elder-friendly surgical unit has on post-operative complications, mortality and quality of life for patients ≥ 65 years old who have undergone emergency surgical care.
The investigators hypothesize that the elder-friendly surgical unit will reduce in-hospital complications and mortality in a cost-effective manner, for this at risk population.
Specific elder-friendly interventions include:
This is a prospective, before-after study with a concurrent control group. Four senior patient groups will be followed:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-Elder Friendly Surgical Intervention Group | Elder Acute Care and Emergency Surgery patients | ||
| Post-Elder Friendly Surgical Intervention Group | Elder Acute Care and Emergency Surgery patients |
| |
| Pre-Elder Friendly Surgical Control Group | Elder Acute Care and Emergency Surgery patients | ||
| Post-Elder Friendly Surgical Control Group |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Elder-Friendly Surgical Unit | Other |
|
| Measure | Description | Time Frame |
|---|---|---|
| Post-Operative complications | Includes a) intensive care unit admission (includes respiratory failure, cardiac arrest or septic shock), b) vascular complications (myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism), c) serious infections (pneumonia, intra-abdominal abscess, urinary tract infection, deep wound infection or infected decubitus ulcer) or d) protracted delirium (≥48 hours) | During initial in-hospital stay (0-12 weeks on average) |
| Death | During initial in-hospital stay (0-12 weeks on average) |
| Measure | Description | Time Frame |
|---|---|---|
| Post-discharge complications or health-events requiring re-admission | Within 30 days post-discharge | |
| Cost per quality-adjusted life year | Both direct and indirect study participant costs | 6 months post-discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Health Related Quality of Life | Including: EQ-5D questionnaire, SF-12 Questionnaire | 6 weeks and 6 months post-discharge |
| Functional Status (Frailty) | Including: Edmonton Frail Scale, and Timed Up-and-Go Test |
Inclusion Criteria:
Exclusion Criteria:
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All patients > 65 years old admitted and received acute abdominal surgery
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| Name | Affiliation | Role |
|---|---|---|
| Rachel G Khadaroo, MD | University of Alberta | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Foothills Medical Center, Acute Care Emergency Surgical Services | Calgary | Alberta | Canada | |||
| University of Alberta Hospital, Acute Care and Emergency Surgery Service |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28836979 | Background | Hanson HM, Warkentin L, Wilson R, Sandhu N, Slaughter SE, Khadaroo RG. Facilitators and barriers of change toward an elder-friendly surgical environment: perspectives of clinician stakeholder groups. BMC Health Serv Res. 2017 Aug 24;17(1):596. doi: 10.1186/s12913-017-2481-z. | |
| 26293153 | Background | Khadaroo RG, Padwal RS, Wagg AS, Clement F, Warkentin LM, Holroyd-Leduc J. Optimizing senior's surgical care - Elder-friendly Approaches to the Surgical Environment (EASE) study: rationale and objectives. BMC Health Serv Res. 2015 Aug 21;15:338. doi: 10.1186/s12913-015-1001-2. |
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| 6 weeks post-discharge |
| Edmonton |
| Alberta |
| Canada |
| 29565018 | Result | Li Y, Pederson JL, Churchill TA, Wagg AS, Holroyd-Leduc JM, Alagiakrishnan K, Padwal RS, Khadaroo RG. Impact of frailty on outcomes after discharge in older surgical patients: a prospective cohort study. CMAJ. 2018 Feb 20;190(7):E184-E190. doi: 10.1503/cmaj.161403. |
| 29368673 | Result | Eamer GJ, Clement F, Pederson JL, Churchill TA, Khadaroo RG. Analysis of postdischarge costs following emergent general surgery in elderly patients. Can J Surg. 2018 Feb;61(1):19-27. doi: 10.1503/cjs.002617. Epub 2017 Dec 1. |
| 29942346 | Result | McComb A, Warkentin LM, McNeely ML, Khadaroo RG. Development of a reconditioning program for elderly abdominal surgery patients: the Elder-friendly Approaches to the Surgical Environment-BEdside reconditioning for Functional ImprovemenTs (EASE-BE FIT) pilot study. World J Emerg Surg. 2018 May 21;13:21. doi: 10.1186/s13017-018-0180-7. eCollection 2018. |
| 33156849 | Derived | Pederson JL, Padwal RS, Warkentin LM, Holroyd-Leduc JM, Wagg A, Khadaroo RG. The impact of delayed mobilization on post-discharge outcomes after emergency abdominal surgery: A prospective cohort study in older patients. PLoS One. 2020 Nov 6;15(11):e0241554. doi: 10.1371/journal.pone.0241554. eCollection 2020. |
| 32049271 | Derived | Khadaroo RG, Warkentin LM, Wagg AS, Padwal RS, Clement F, Wang X, Buie WD, Holroyd-Leduc J. Clinical Effectiveness of the Elder-Friendly Approaches to the Surgical Environment Initiative in Emergency General Surgery. JAMA Surg. 2020 Apr 1;155(4):e196021. doi: 10.1001/jamasurg.2019.6021. Epub 2020 Apr 15. |
| 31036332 | Derived | Eamer GJ, Clement F, Holroyd-Leduc J, Wagg A, Padwal R, Khadaroo RG. Frailty predicts increased costs in emergent general surgery patients: A prospective cohort cost analysis. Surgery. 2019 Jul;166(1):82-87. doi: 10.1016/j.surg.2019.01.033. Epub 2019 Apr 27. |