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The Effect on Patient Outcomes Usage of Comprehensive Geriatric Assessment Method in Elderly Before Surgery : Systematic Literature Review

Yıl 2021, Cilt: 4 Sayı: 1, 14 - 20, 29.01.2021

Öz

Changes that occur with the aging process affect the functional, physiological and social well-being of individuals. Therefore, evaluation and care of elderly patients are very important. This systematic review was conducted to examine studies involving the use of the comprehensive geriatric assessment method which is used for the evaluation of elderly patients before surgery. The systematic review was based on“PRISMA-P” guideline. Med-Line, Science Direct, Scopus, Pubmed, Google Academic and National Thesis Center were used as research databases. In the review, screening was performed using the keywords "preoperative", "comprehensive geriatric assessment", "risk assessment", "elderly". The systematic review included studies published in 2000-2017, with a publication language in Turkish and English, with full-text access. A total of 21 articles were included in the study as a result of the literature review. In 19 of these studies, it was determined that comprehensive geriatric assessment before surgery played an important role in determining the postoperative complication risk. In other 2 studies, it was found that geriatric assessment did not decrease complication, re-hospitalization, re-operation and death rates. Studies show that the comprehensive evaluation of pre-operative elderly patients is effective in reducing and preventing adverse outcomes that may develop after surgery.

Kaynakça

  • Abete P, Cherubini A, Di Bari M, Vigorito C, Viviani G, Marchionni N, et al. (2016). Does comprehensive geriatric assessment improve the estimate of surgical risk in elderly patients? An Italian multicenter observational study. The American Journal of Surgery, 211(1): 76-83. doi: 10.1016/j.amjsurg.2015.04.016.
  • Benjamin AJ, Buschmann MM, Schneider A, Derstine BA,Friedman JF, Wang SC, et al. (2017). Can comprehensive imaging analysis with analytic morphomics and geriatric assessment predict serious complications in patients undergoing pancreatic surgery?. Journal of Gastrointestinal Surgery, 21(6): 1009-1016. doi: 10.1007/s11605-017-3392-3
  • Bettelli G. (2010). Anaesthesia for the elderly outpatient: Preoperative assessment and evaluation, anaesthetic technique and postoperative pain management. CurrentOpinion in Anesthesiology, 23(6): 726-731. doi: 10.1097/ACO.0b013e3283400b6c
  • Choi JY, Yoon SJ, Kim SW, Jung HW, Kim KI, Kang E, et al.(2015). Prediction of postoperative complications using multidimensional frailty score in older female cancer patients with American Society of Anesthesiologists physical status class 1 or 2. Journal of the American College of Surgeons, 221(3): 652-660. doi: 10.1016/j.jamcollsurg.2015.06.011
  • Çelik S, Kavacık D, Nair A, Şeker N, Demirel L. (2015). Cerrahigirişim geçiren yaşlı hastalarda bilişsel fonksiyonbozukluğunun değerlendirilmesi. Bakırköy Tıp Dergisi, 11(2):66-73.
  • Dale W, Hemmerich J, Kamm A, Posner MC, Matthews JB,Rothman R, et al. (2014). Geriatric assessment improves prediction of surgical outcomes in older adults undergoing pancreaticoduodenectomy: a prospective cohort study. Annals of Surgery, 259(5): 960-965. doi: 10.1097/SLA.0000000000000226
  • Damulevičienė G, Lesauskaitė V, Macijauskienė J, ŠmigelskasK, Venskutonis D. (2013). Perioperative Factors affecting length of Hospital stay among elderly Patients.Medicina,49(6): 40.19dergipark.gov.tr/avrasyasbd
  • Seyhan Ak, Karaman & KananEamer G, Taheri A, Chen SS, Daviduck Q, Chambers T, Shi X,et al. (2018) Comprehensive geriatric assessment for older people admitted to a surgical service. Cochrane DatabaseSystematicReviews, 1: CD012485.
  • Feng MA, McMillan DT, Crowell K, Muss H, Nielsen ME, SmithAB. (2015). Geriatric assessment in surgical oncology: a systematic review. Journal of Surgical Research, 193(1):265-272. doi: 10.1016/j.jss.2014.07.004.
  • Fukuse T, Satoda N, Hijiya K, Takuji F. (2005). Importance of a comprehensive geriatric assessment in prediction of complications following thoracic surgery in elderly patients. Chest, 127(3): 886-891.
  • Harari D, Hopper A, Dhesi J, Babic-Illman G, Lockwood L, Martin F. (2007). Proactive care of older people undergoing surgery (‘POPS’): designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients. Age and Ageing, 36(2): 190-196.
  • Indrakusuma R, Dunker MS, Peetoom JJ, Schreurs WH. (2015).Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study.European Journal of Surgical Oncology (EJSO), 41(1): 21-27.doi: 10.1016/j.ejso.2014.09.005
  • Jeong YM, Lee E, Kim KI, Chung JE, Park HI, Lee BK, GwakH.S. (2016). Association of pre-operative medication use with post-operative delirium in surgical oncology patients receiving the comprehensive geriatric assessment. BMCGeriatrics, 16(1): 134. doi: 10.1186/s12877-016-0311-5
  • Kenig J, Wałęga P, Olszewska U, Konturek A, Nowak W. (2016).Geriatric assessment as a qualification element for elective and emergency cholecystectomy in older patients. WorldJournal of Emergency Surgery, 11(1): 36. doi: 10.1186/s13017-016-0094-1
  • Kim KI, Park KH, Koo KH, Han HS, Kim CH. (2013). Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgery. Archives of Gerontology and Geriatrics, 56(3): 507-512. doi: 10.1016/j.archger.2012.09.002
  • Kristjansson SR, Jordhøy MS, Nesbakken A, Skovlund E,Bakka A, Johannessen HO, et al. (2010). Which elements of a comprehensive geriatric assessment (CGA) predict post-operative complications and early mortality after colorectal cancer surgery?. Journal of Geriatric Oncology,1(2): 57-65.
  • Lasithiotakis K, Petrakis J, Venianaki M, Georgiades G,Koutsomanolis D, Andreou A, et al. (2013). Frailty predicts outcome of elective laparoscopic cholecystectomy in geriatric patients. Surgical Endoscopy,27(4): 1144-1150. doi:10.1007/s00464-012-2565-0
  • Lee YH, Oh HK, Kim DW, Ihn MH, Kim JH, Son IT, et al. (2016). Use of a comprehensive geriatric assessment to predict short-term postoperative outcome in elderly patients with colorectal cancer. Annals of Coloproctology, 32(5): 161.
  • Mazzola P, Ward L, Zazzetta S, Broggini V, Anzuini A, ValcarcelB, et al. (2017). Association between preoperative malnutrition and postoperative delirium after hip fracture surgery in older adults. Journal of the American GeriatricsSociety, 65(6): 1222-1228. doi: 10.1111/jgs.14764.
  • Ommundsen N, Wyller TB, Nesbakken A, Bakka AO, JordhøyMS, Skovlund E, Rostoft S. (2018). Preoperative geriatric assessment and tailored interventions in frail older patients with colorectal cancer: a randomized controlled trial. Colorectal Disease, 20(1): 16-25.
  • Pajulammi HM, Pihlajamäki HK, Luukkaala TH, JousmäkiJJ, Jokipii PH, Nuotio MS. (2017). The effect of an in-hospital comprehensive geriatric assessment on short-term mortality during Orthogeriatric hip fracture program—which patients benefit the Most?. GeriatricOrthopaedic Surgery & Rehabilitation, 8(4): 183-191. doi:10.1177/2151458517716516
  • Partridge JSL, Harari D, Martin FC, Dhesi JK. (2014). The impact of pre-operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review. Anaesthesia, 69:8-16. doi: 10.1111/anae.12494
  • Partridge JSL, Harari D, Martin FC, Peacock JL, Bell R, Mohammed A, et al. (2017). Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery. British Journal of Surgery, 104(6): 679-687. doi: 10.1002/bjs.10459
  • Savaş S, Akçiçek F. (2010). Kapsamlı geriatrik değerlendirme.Ege Tıp Dergisi, 49(10): 19-30.
  • Savcı A, Bilik Ö. (2014). Ortopedi ve travmatoloji kliniğindegeriatrik değerlendirme. Dokuz Eylül ÜniversitesiHemşirelik Fakültesi Elektronik Dergisi, 7(2): 156-163.
  • Suh DH, Kim JW, Kim HS, Chung HH, Park NH, Song YS. (2014).Pre-and intra-operative variables associated with surgical complications in elderly patients with gynecologic cancer: the clinical value of comprehensive geriatric assessment.Journal of Geriatric Oncology, 5(3): 315-322. doi: 10.1016/j.jgo.2014.03.004
  • Watne LO, Torbergsen AC, Conroy S, Engedal K, FrihagenF, Hjorthaug GA, et al. (2014). The effect of a pre-and postoperative orthogeriatric service on cognitive function in patients with hip fracture: randomized controlled trial(Oslo Orthogeriatric Trial). BMC Medicine, 12(1): 63. doi:10.1186/1741-7015-12-63.
  • World Health Organization (2018). Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-andhealth.Erişim tarihi:09.10.2020.
  • Yamamoto M, Yamasaki M, Sugimoto K, Maekawa Y, MiyazakiY, Makino T, et al. (2016). Risk evaluation of postoperative delirium using comprehensive geriatric assessment in elderly patients with oesophagal cancer. World Journal of Surgery, 40(11): 2705-2712.

Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi

Yıl 2021, Cilt: 4 Sayı: 1, 14 - 20, 29.01.2021

Öz

Yaşlanma süreciyle birlikte meydana gelen değişiklikler bireylerin işlevsel, fizyolojik ve sosyal refahını etkilemektedir. Bu nedenle yaşlıhastaların değerlendirilmesi ve bakımı oldukça önemlidir. Bu sistematik derleme, yaşlı hastaların ameliyat öncesi değerlendirilmesindekullanılan kapsamlı geriatrik değerlendirme yönteminin kullanımını içeren çalışmaları incelemek amacıyla yapıldı. Sistematik derlemedePRİSMA-P rehberi esas alındı. Araştırma veri tabanları olarak Med-Line, Science Direct, Scopus, Pubmed, Google Akademik ve Ulusal TezMerkezi kullanıldı. Derlemede ameliyat öncesi “preoperative”, kapsamlı geriatrik değerlendirme “comprehensive geriatric assessment”,risk değerlendirmesi “risk assessment”, yaşlı “elderly” anahtar kelimeleri kullanılarak tarama yapıldı. Sistematik derlemeye 2000-2017 yıllarıarasında yayınlanan, yayın dili Türkçe ve İngilizce olan, tam metin erişimi bulunan araştırmalar dahil edildi. Literatür taraması sonucu 21 makaleçalışma kapsamına alındı. Çalışmaların 19’unda yaşlı hastalarda ameliyat öncesi yapılan kapsamlı geriatrik değerlendirmenin ameliyat sonrasıkomplikasyon riskini belirlemede önemli rol oynadığı belirlenirken, 2 çalışmada geriatrik değerlendirmenin komplikasyon görülme, tekrarhastaneye yatış, tekrar ameliyat olma ve ölüm oranlarını azaltmadığı saptanmıştır. Çalışmalar ameliyat öncesi yaşlı hastaların kapsamlı birşekilde değerlendirilmesinin ameliyat sonrası gelişebilecek olumsuz sonuçların azaltılması ve önlenmesinde etkili olduğunu göstermektedir.

Kaynakça

  • Abete P, Cherubini A, Di Bari M, Vigorito C, Viviani G, Marchionni N, et al. (2016). Does comprehensive geriatric assessment improve the estimate of surgical risk in elderly patients? An Italian multicenter observational study. The American Journal of Surgery, 211(1): 76-83. doi: 10.1016/j.amjsurg.2015.04.016.
  • Benjamin AJ, Buschmann MM, Schneider A, Derstine BA,Friedman JF, Wang SC, et al. (2017). Can comprehensive imaging analysis with analytic morphomics and geriatric assessment predict serious complications in patients undergoing pancreatic surgery?. Journal of Gastrointestinal Surgery, 21(6): 1009-1016. doi: 10.1007/s11605-017-3392-3
  • Bettelli G. (2010). Anaesthesia for the elderly outpatient: Preoperative assessment and evaluation, anaesthetic technique and postoperative pain management. CurrentOpinion in Anesthesiology, 23(6): 726-731. doi: 10.1097/ACO.0b013e3283400b6c
  • Choi JY, Yoon SJ, Kim SW, Jung HW, Kim KI, Kang E, et al.(2015). Prediction of postoperative complications using multidimensional frailty score in older female cancer patients with American Society of Anesthesiologists physical status class 1 or 2. Journal of the American College of Surgeons, 221(3): 652-660. doi: 10.1016/j.jamcollsurg.2015.06.011
  • Çelik S, Kavacık D, Nair A, Şeker N, Demirel L. (2015). Cerrahigirişim geçiren yaşlı hastalarda bilişsel fonksiyonbozukluğunun değerlendirilmesi. Bakırköy Tıp Dergisi, 11(2):66-73.
  • Dale W, Hemmerich J, Kamm A, Posner MC, Matthews JB,Rothman R, et al. (2014). Geriatric assessment improves prediction of surgical outcomes in older adults undergoing pancreaticoduodenectomy: a prospective cohort study. Annals of Surgery, 259(5): 960-965. doi: 10.1097/SLA.0000000000000226
  • Damulevičienė G, Lesauskaitė V, Macijauskienė J, ŠmigelskasK, Venskutonis D. (2013). Perioperative Factors affecting length of Hospital stay among elderly Patients.Medicina,49(6): 40.19dergipark.gov.tr/avrasyasbd
  • Seyhan Ak, Karaman & KananEamer G, Taheri A, Chen SS, Daviduck Q, Chambers T, Shi X,et al. (2018) Comprehensive geriatric assessment for older people admitted to a surgical service. Cochrane DatabaseSystematicReviews, 1: CD012485.
  • Feng MA, McMillan DT, Crowell K, Muss H, Nielsen ME, SmithAB. (2015). Geriatric assessment in surgical oncology: a systematic review. Journal of Surgical Research, 193(1):265-272. doi: 10.1016/j.jss.2014.07.004.
  • Fukuse T, Satoda N, Hijiya K, Takuji F. (2005). Importance of a comprehensive geriatric assessment in prediction of complications following thoracic surgery in elderly patients. Chest, 127(3): 886-891.
  • Harari D, Hopper A, Dhesi J, Babic-Illman G, Lockwood L, Martin F. (2007). Proactive care of older people undergoing surgery (‘POPS’): designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients. Age and Ageing, 36(2): 190-196.
  • Indrakusuma R, Dunker MS, Peetoom JJ, Schreurs WH. (2015).Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study.European Journal of Surgical Oncology (EJSO), 41(1): 21-27.doi: 10.1016/j.ejso.2014.09.005
  • Jeong YM, Lee E, Kim KI, Chung JE, Park HI, Lee BK, GwakH.S. (2016). Association of pre-operative medication use with post-operative delirium in surgical oncology patients receiving the comprehensive geriatric assessment. BMCGeriatrics, 16(1): 134. doi: 10.1186/s12877-016-0311-5
  • Kenig J, Wałęga P, Olszewska U, Konturek A, Nowak W. (2016).Geriatric assessment as a qualification element for elective and emergency cholecystectomy in older patients. WorldJournal of Emergency Surgery, 11(1): 36. doi: 10.1186/s13017-016-0094-1
  • Kim KI, Park KH, Koo KH, Han HS, Kim CH. (2013). Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgery. Archives of Gerontology and Geriatrics, 56(3): 507-512. doi: 10.1016/j.archger.2012.09.002
  • Kristjansson SR, Jordhøy MS, Nesbakken A, Skovlund E,Bakka A, Johannessen HO, et al. (2010). Which elements of a comprehensive geriatric assessment (CGA) predict post-operative complications and early mortality after colorectal cancer surgery?. Journal of Geriatric Oncology,1(2): 57-65.
  • Lasithiotakis K, Petrakis J, Venianaki M, Georgiades G,Koutsomanolis D, Andreou A, et al. (2013). Frailty predicts outcome of elective laparoscopic cholecystectomy in geriatric patients. Surgical Endoscopy,27(4): 1144-1150. doi:10.1007/s00464-012-2565-0
  • Lee YH, Oh HK, Kim DW, Ihn MH, Kim JH, Son IT, et al. (2016). Use of a comprehensive geriatric assessment to predict short-term postoperative outcome in elderly patients with colorectal cancer. Annals of Coloproctology, 32(5): 161.
  • Mazzola P, Ward L, Zazzetta S, Broggini V, Anzuini A, ValcarcelB, et al. (2017). Association between preoperative malnutrition and postoperative delirium after hip fracture surgery in older adults. Journal of the American GeriatricsSociety, 65(6): 1222-1228. doi: 10.1111/jgs.14764.
  • Ommundsen N, Wyller TB, Nesbakken A, Bakka AO, JordhøyMS, Skovlund E, Rostoft S. (2018). Preoperative geriatric assessment and tailored interventions in frail older patients with colorectal cancer: a randomized controlled trial. Colorectal Disease, 20(1): 16-25.
  • Pajulammi HM, Pihlajamäki HK, Luukkaala TH, JousmäkiJJ, Jokipii PH, Nuotio MS. (2017). The effect of an in-hospital comprehensive geriatric assessment on short-term mortality during Orthogeriatric hip fracture program—which patients benefit the Most?. GeriatricOrthopaedic Surgery & Rehabilitation, 8(4): 183-191. doi:10.1177/2151458517716516
  • Partridge JSL, Harari D, Martin FC, Dhesi JK. (2014). The impact of pre-operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review. Anaesthesia, 69:8-16. doi: 10.1111/anae.12494
  • Partridge JSL, Harari D, Martin FC, Peacock JL, Bell R, Mohammed A, et al. (2017). Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery. British Journal of Surgery, 104(6): 679-687. doi: 10.1002/bjs.10459
  • Savaş S, Akçiçek F. (2010). Kapsamlı geriatrik değerlendirme.Ege Tıp Dergisi, 49(10): 19-30.
  • Savcı A, Bilik Ö. (2014). Ortopedi ve travmatoloji kliniğindegeriatrik değerlendirme. Dokuz Eylül ÜniversitesiHemşirelik Fakültesi Elektronik Dergisi, 7(2): 156-163.
  • Suh DH, Kim JW, Kim HS, Chung HH, Park NH, Song YS. (2014).Pre-and intra-operative variables associated with surgical complications in elderly patients with gynecologic cancer: the clinical value of comprehensive geriatric assessment.Journal of Geriatric Oncology, 5(3): 315-322. doi: 10.1016/j.jgo.2014.03.004
  • Watne LO, Torbergsen AC, Conroy S, Engedal K, FrihagenF, Hjorthaug GA, et al. (2014). The effect of a pre-and postoperative orthogeriatric service on cognitive function in patients with hip fracture: randomized controlled trial(Oslo Orthogeriatric Trial). BMC Medicine, 12(1): 63. doi:10.1186/1741-7015-12-63.
  • World Health Organization (2018). Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-andhealth.Erişim tarihi:09.10.2020.
  • Yamamoto M, Yamasaki M, Sugimoto K, Maekawa Y, MiyazakiY, Makino T, et al. (2016). Risk evaluation of postoperative delirium using comprehensive geriatric assessment in elderly patients with oesophagal cancer. World Journal of Surgery, 40(11): 2705-2712.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Ezgi Seyhan Ak 0000-0002-3679-539X

Ahmet Karaman 0000-0001-6662-3997

Nevin Kanan 0000-0002-2852-2316

Yayımlanma Tarihi 29 Ocak 2021
Gönderilme Tarihi 18 Haziran 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 4 Sayı: 1

Kaynak Göster

APA Seyhan Ak, E., Karaman, A., & Kanan, N. (2021). Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi. Avrasya Sağlık Bilimleri Dergisi, 4(1), 14-20.
AMA Seyhan Ak E, Karaman A, Kanan N. Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi. AvrasyaSBD. Ocak 2021;4(1):14-20.
Chicago Seyhan Ak, Ezgi, Ahmet Karaman, ve Nevin Kanan. “Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi”. Avrasya Sağlık Bilimleri Dergisi 4, sy. 1 (Ocak 2021): 14-20.
EndNote Seyhan Ak E, Karaman A, Kanan N (01 Ocak 2021) Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi. Avrasya Sağlık Bilimleri Dergisi 4 1 14–20.
IEEE E. Seyhan Ak, A. Karaman, ve N. Kanan, “Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi”, AvrasyaSBD, c. 4, sy. 1, ss. 14–20, 2021.
ISNAD Seyhan Ak, Ezgi vd. “Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi”. Avrasya Sağlık Bilimleri Dergisi 4/1 (Ocak 2021), 14-20.
JAMA Seyhan Ak E, Karaman A, Kanan N. Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi. AvrasyaSBD. 2021;4:14–20.
MLA Seyhan Ak, Ezgi vd. “Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi”. Avrasya Sağlık Bilimleri Dergisi, c. 4, sy. 1, 2021, ss. 14-20.
Vancouver Seyhan Ak E, Karaman A, Kanan N. Yaşlılarda Ameliyat Öncesi Kapsamlı Geriatrik Değerlendirme Yönteminin Kullanımı: Sistematik Literatür İncelemesi. AvrasyaSBD. 2021;4(1):14-20.