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Pilot Study of a Surgical-Oncology Geriatric Co-Management Program

机译:手术肿瘤性老年共同管理计划的试验研究

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Abstract Purpose: This study aims to evaluate clinical outcomes of a pilot co-management model for patients 65 years and older that were referred by their surgical oncologist for a comprehensive geriatric assessment prior to surgery. Methods: A retrospective chart review was conducted for 9 patients. Patients’ pre-operative Charlson Comorbidity Index (CCI) and frailty index were measured. Additional measures included advanced care planning (ACP) documentation and whether patients transferred primary care. Post-operative courses and complications were followed, including length of stay (LOS) and discharge outcomes. Results: A total of 9 patient charts were reviewed. The average age was 79 years. The average CCI and frailty indices were 9 and 4, respectively. Every patient had ACP during the initial assessment. Five patients had multiple outpatient geriatrician visits. Of the 9 referrals, 7 proceeded with surgery. LOS ranged from 6 – 22 days, with a median and average of 8 and 11 days, respectively. Of those undergoing surgery, 4 had an inpatient geriatrics consult. Complications included 1 mortality, 2 aborted cases and 4 with other complications. Four patients were discharged to previous living situations and 2 to SAR. Two patients had one ED/UC visit and 2 had multiple readmissions. No patients transferred their primary care. Conclusion: This is a small pilot showing a promising collaboration between geriatrics and surgical oncology. It outlines a supportive framework for initial and peri-operative geriatric assessments with favorable experiences for both providers. More studies are necessary to make clinical associations with this co-management model.
机译:摘要目的:本研究旨在评估65岁及以上患者的试点共同管理模型的临床结果,这些模型由其外科肿瘤科学家在手术前进行综合性老年评估。方法:进行追溯图表审查9名患者。测量患者的术前夏尔森合并症指数(CCI)和脆弱指数。额外措施包括先进的护理计划(ACP)文件以及患者是否转移初级保健。遵循术后课程和并发症,包括逗留时间(LOS)和排放结果。结果:综述了共有9个患者图表。平均年龄为79岁。平均CCI和脆弱指数分别为9和4。在初始评估期间,每位患者都有ACP。五名患者有多个门诊老年人访问。在9个推荐中,7次进行手术。洛杉矶范围从6-22天,中位数和平均分别为8和11天。在接受手术的人中,4人有一个住院性的老年教学咨询。并发症包括1个死亡率,2例中产病和4个其他并发症。四名患者被排放到以前的生活情况和2到SAR。两名患者有一个ED / UC访问,2名患者进行了多次入伍。没有患者转移初级保健。结论:这是一名小型飞行员,表现出老年学历与外科肿瘤之间有前途的合作。它概述了初始和Peri-iling Geriatric评估的支持性框架,对两个提供商有利的经验。更多的研究是与该共同管理模型进行临床关联必需的。

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