O-81: Designing a Geriatric Liaison Service for older emergency general surgical patients—aims and initial experience

摘要

Introduction: National guidelines produced by The Association of Anaesthetists of Great Britain and Ireland state that optimal peri-operative care of the older people should integrate senior geriatrician expertise [1]. Methods: Based on these recommendations a Geriatric Liaison Services has been set up for selected patients over the age of 70 admitted under general surgery. The aims of which are (1) provision of specialist advise and recommendations to improve care of patients with frailty, (2) identification of acute or underlying medical conditions The service provides a comprehensive medical review by a consultant geriatrician. Patients meeting referral criteria are identified and referred by senior nurses across the general surgical wards. These patients are then reviewed on a biweekly consultant ward round. A bespoke problem list is generated for each patient and recommendations provided for the management of each identified problem. Results: Over a period of 21 weeks 112 patients were reviewed. The mean age was 83.8 years old, number of co- morbidities was 4.75, number of new medical diagnoses was 2.75 and number of recommendations for optimisation of care and management was 6.1. Over 70% of patients were reviewed within 3 days of admission. Conclusions: Our initial experience has demonstrated that there is significant demand for geriatric expertise in this group of patients. Every review yielded recommendations for optimisation of care and hence all referrals were appropriate. We have found that our referral criteria are a robust means of identifying appropriate patients and that the timely delivery of this service is feasible.