Perioperative Optimization of Senior Health (POSH): A Descriptive Analysis of Cancelled Surgery.

Abstract:

BACKGROUND:Geriatric collaborative care models improve postoperative outcomes for older adults. However, there are limited data exploring how preoperative geriatric assessment may affect surgical cancellations. METHODS:This is a single-center retrospective cohort analysis. Patients enrolled in the Perioperative Optimization of Senior Health (POSH) program from 2011 to 2016 were included. POSH is a collaborative care model between geriatrics, surgery, and anesthesiology. Baseline demographic and medical data were collected during the POSH pre-op appointment. Patients who attended a POSH pre-op visit but did not have surgery were identified, and a chart review was performed to identify reasons for surgical cancellation. Baseline characteristics of patients who did and did not undergo surgery were compared. RESULTS:Of 449 eligible POSH referrals within the study period, 33 (7.3%) did not proceed to surgery; cancellation rates within the POSH program were lower than institutional cancellation rates for adults over age 65 who did not participate in POSH. Patients who did not have surgery were significantly older, more likely to have functional limitations, and had higher rates of several comorbidities compared with those who proceeded to surgery (P < 0.05). Reasons for surgical cancellations included a similar number of patient- and provider-driven causes. CONCLUSIONS:Many reasons for surgical cancellation were related to potentially modifiable factors, such as changes in goals of care or concerns about rehabilitation, emphasizing the importance of shared decision-making in elective surgery for older adults. These results highlight the important role geriatric collaborative care can offer to older adults with complex needs.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Zietlow KE,Wong S,McDonald SR,Colón-Emeric C,Cassas C,Lagoo-Deenadayalan S,Heflin MT

doi

10.1007/s00268-020-05772-z

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

109-115

issue

1

eissn

0364-2313

issn

1432-2323

pii

10.1007/s00268-020-05772-z

journal_volume

45

pub_type

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