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The GENEUS 1 study addresses this gap by characterizing the real-world profiles, outcomes, and care pathways of adults aged 65 years and older hospitalized in neurosurgery across France, Spain, and Portugal. This project represents the first multicentre, transnational initiative to integrate geriatric principles into neurosurgical practice and to evaluate both clinical and economic outcomes in this population.
This is a prospective, multicentre, multinational, observational study.
Seven neurosurgical centres in France, Spain, and Portugal will participate. Each participant will be followed at three timepoints:
V0 (Admission): baseline clinical and geriatric assessment. V1 (Discharge): length of stay, complications, and updated functional and cognitive status.
V2 (3 months ±1 week): structured telephone follow-up or face-to-face visit to assess readmission, autonomy, and quality of life.
A 12-month medico-economic component (only in France) will evaluate healthcare utilization and costs using clinical data, patient or caregiver questionnaires, and linkage with the Système National des Données de Santé (SNDS) in France.
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| Measure | Description | Time Frame |
|---|---|---|
| The evolution of functional autonomy between baseline and 3 months post-discharge | The change is measured using validated geriatric scale Basic Activities of Daily Living Functional decline will be defined as any clinically significant decrease in ADL score compared with baseline. The change will be expressed both as a continuous variable (score variation) and as a categorical outcome (improved / stable / declined autonomy). This criterion captures the short-term functional trajectory of older adults after a neurosurgical hospitalization and serves as the main indicator of care effectiveness and adaptation to geriatric needs. | between baseline and 3-month after discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | Number of days from admission to discharge. | baseline until the day of hospital discharge |
| Postoperative complications | Complications classified according to the Clavien-Dindo scale |
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Inclusion criteria:
Age ≥ 65 years at the time of admission Admission to a neurosurgery department in one of the participating centres (France, Spain, or Portugal), Affiliation with a national health-insurance or equivalent system Feasibility of follow-up at 3 months, Consent/non-opposition for the study
Exclusion Criteria:
Terminal illness (neurosurgical or not) with an estimated life expectancy of < 3 months.
Loss of autonomy prior to admission, established as ADL < 3. For a patient admitted to the emergency hospital, ask him (or his caregiver) about his functional abilities before his condition deteriorated.
Legal protection status (guardianship, trusteeship, or judicial protection) when such status prevents lawful consent or non-opposition.
Participation in another interventional clinical study whose procedures or follow-up could interfere with GENEUS 1 objectives or endpoints.
Severe cognitive or communication impairment
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Patients aged 65 years or older admitted for neurosurgical intervention, for whom follow-up for 3 months is possible given their cognitive status and life expectancy, and who agrees to the retrieval of their hospital clinical and health economic data during the year following their discharge from the hospital
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eric SCHMIDT | Contact | 05 61 77 56 06 | +33 | schmidt.e@chu-toulouse.fr |
| Veronique CHAIGNEAU | Contact | chaigneau.v@chu-toulouse.fr |
| Name | Affiliation | Role |
|---|---|---|
| Eric SCHMIDT | University Hospital of Toulouse | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Limoges University Hospital | Limoges | France |
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| the day of the hospital discharge |
| Daily living | scoring of the scale : instrumental activities of daily living (IADL) score 0 is the worst, score 8 is the best autonomy | baseline, the day of hospital discharge and 3-month after discharge |
| Composite criteria of Cognitive status and delirium composed of 3 criteriaes | first criteria : score of the scale of Sclan and Reisberg - score is between 1 and 7 - 1 is the better and 7 the worst second criteria : score of the test for delirium & cognitive impairment (4AT) - the score is beetwen 0 and 4 - 0 is the better and 4 the worst third criteria : Mini Mental State Examination | baseline and the day of hospital discharge |
| Psychological status | Scoring of the Patient Health Questionnaire (GDS4) - score is 0 to 4 - 0 is not depressed - 4 is very depressed | baseline and 3month after discharge |
| Frailtry | scoring of CFS (clinical Frailty scale) - score from 1 to 9 (scores of 1-3 are considered non-frail, 4 to be pre-frail, 5-8 as frail and 9 as terminally ill) | baseline, day of hospital discharge and 3 month after discharge |
| Quality of life score | Scoring of the EQ-5D-5L questionnaire (score from 0 to 100 - 0 is better and 100 is the worst) | baseline, day of hospital discharge, and 3 months after discharge |
| Composite criteria composed of two criteriaes : functional recovery and autonomy evolution | Scoring of Activities of Daily Living (ADL) : score 0 to 6 : score of 0 is the worst and score 6 is the best and instrumental activities of daily living (IADL scale) score 0 is the worst, score 8 is the best autonomy | 3 months after discharge |
| CUF Descobertas | Lisbon | Portugal |
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| ULS Santa Maria | Lisbon | Portugal |
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| Hospital General Universitario Alicante | Alicante | Spain |
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| Complexo Hospitalario De Ourense | Ourense | Spain |
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| Navarrabiomed | Pamplona | Spain |
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