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Randomized Controlled Trial
. 2016 Feb 22;11(2):e0143364.
doi: 10.1371/journal.pone.0143364. eCollection 2016.

Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients

Liesbeth Hempenius  1   2 , Joris P J Slaets  1 , Dieneke van Asselt  3 , Truuske H de Bock  4 , Theo Wiggers  5 , Barbara L van Leeuwen  5
Affiliations
Randomized Controlled Trial

Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients

Liesbeth Hempenius et al. PLoS One. .

Abstract

Background: The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.

Methods: A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL) functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.

Results: Data of 260 patients (intervention n = 127, Control n = 133) were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88), an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87) and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49).

Conclusions: A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.

Trial registration: Nederlands Trial Register, Trial ID NTR 823.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. CONSORT diagram for the study.
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