干旱区生态环境知识资源中心(Arid): Implementation of a geriatric in-reach service improves acute surgical unit outcomes; a retrospective before-and-after study

Arid

DOI	10.1111/ans.19026
	Implementation of a geriatric in-reach service improves acute surgical unit outcomes; a retrospective before-and-after study
	Pugliese, Matthew; Connell, Louis; Turco, Jennifer; Trivedi, Anand; Foster, Amanda; Kumarasinghe, Anuttara Panchali W.
通讯作者	Pugliese, M
来源期刊	ANZ JOURNAL OF SURGERY
ISSN	1445-1433
EISSN	1445-2197
出版年	2024
卷号	94 期号:7-8 页码:1349-1355
英文摘要	Background: Australia's ageing population is challenging for surgical units and there is a paucity of evidence for geriatric co-management in acute general surgery. We aimed to assess if initiating a Geriatric Medicine in-reach service improved outcomes for older adults in our Acute Surgical Unit (ASU). Methods: The Older Adult Surgical Inpatient Service (OASIS) was integrated into ASU in 2021. We retrospectively reviewed all patients over age 65 admitted to ASU over a 12-month period before and after service integration with a length of stay (LOS) greater than 24 h. There was no subsequent truncation or selection. Primary outcomes were 30-day mortality, LOS, and 28-day readmissions. Secondary outcomes were discharge disposition, in-hospital mortality, and hospital-acquired complications (HACs). Results: 1339 consecutive patients were included in each group, with no differences in baseline characteristics. There was a significant decrease in 28-day readmissions from 20.2% to 16.0% (P < 0.05), greatest in patients undergoing non-EL operative procedures (21.9% pre-OASIS vs. 12.6% post-OASIS; P < 0.05). Trends towards reduced 30-day mortality (7.17% vs. 5.90%; P = 0.211), in-hospital mortality (3.88% vs. 2.91%; P = 0.201), permanent care placement (7.77% vs. 7.09%; P = 0.843) and HACs (8.14% vs. 7.62%; P = 0.667) were seen, although statistical significance was not demonstrated. LOS remained unchanged at 4 days (P = 0.653). Conclusion: The addition of a geriatric in-reach service to a tertiary ASU led to a significant reduction in 28-day readmissions. Downtrends were seen in mortality, permanent care placement, and HAC rates, while LOS remained unchanged.
英文关键词	co-management general surgery geriatric medicine geriatrics readmissions service design
类型	Article
语种	英语
开放获取类型	hybrid
收录类别	SCI-E
WOS记录号	WOS:001217610400001
WOS类目	Surgery
WOS研究方向	Surgery
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/402841
推荐引用方式 GB/T 7714	Pugliese, Matthew,Connell, Louis,Turco, Jennifer,et al. Implementation of a geriatric in-reach service improves acute surgical unit outcomes; a retrospective before-and-after study[J],2024,94(7-8):1349-1355.
APA	Pugliese, Matthew,Connell, Louis,Turco, Jennifer,Trivedi, Anand,Foster, Amanda,&Kumarasinghe, Anuttara Panchali W..(2024).Implementation of a geriatric in-reach service improves acute surgical unit outcomes; a retrospective before-and-after study.ANZ JOURNAL OF SURGERY,94(7-8),1349-1355.
MLA	Pugliese, Matthew,et al."Implementation of a geriatric in-reach service improves acute surgical unit outcomes; a retrospective before-and-after study".ANZ JOURNAL OF SURGERY 94.7-8(2024):1349-1355.