The Impact of Perioperative Geriatric Care on Outcomes After Elective Noncardiac Surgery

Mortality Clinical Trial

Official title:

The Impact of Perioperative Geriatric Care on Outcomes After Elective Noncardiac Surgery

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02975375
• Other study ID #: DM4
• Status: Completed
• Phase: N/A
• First received: November 17, 2016
• Last updated: December 6, 2016
• Start date: April 2002
• Est. completion date: November 2016

Study information

• Verified date: December 2016
• Source: Ottawa Hospital Research Institute
• Contact: n/a
• Is FDA regulated: No
• Health authority: Canada: Ethics Review Committee
• Study type: Observational

Clinical Trial Summary

The investigators will conduct a population-based study using health administrative data to evaluate the impact of preoperative geriatric consultation on postoperative outcomes in older patients having elective, non-cardiac surgery

Description:

The investigators will use multilevel multivariable analyses to measure the association between preoperative geriatric assessment or consultation and outcomes after major elective non-cardiac surgery. Sensitivity analyses will be done to evaluate types and timing of geriatric care around surgery, as well as for effect modification based on patient and procedural factors.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 200000
• Est. completion date: November 2016
• Est. primary completion date: March 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

• >65

• Resident of Ontario

• Having elective non-cardiac surgery (inpatient admission)

Exclusion Criteria:

• Residing in a nursing home or long term care facility at baseline

Study Design

Observational Model: Cohort, Time Perspective: Retrospective

Related Conditions & MeSH terms

• Aged
• Epidemiology
• Mortality
• SURGICAL PROCEDURES, OPERATIVE

Intervention

Procedure:
• Preoperative geriatric consult or assessment
A preoperative geriatric consult or assessment will be considered to be present if such a consult or assessment is billed by a geriatrician for a patient in the cohort within 4 months preceding surgery. For the primary analysis we will collapse both geriatric consultations and comprehensive geriatric assessments into a single exposure level.
• No Preoperative geriatric consult or assessment
No assessment or consult billed in the 4 months before surgery

Locations

Country	Name	City	State
Canada	Ottawa Hospital Research Institute	Ottawa	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
Ottawa Hospital Research Institute

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	90-day survival	Death from any cause in the 90 days after surgery	date of surgery to day of death or 365 days after surgery, whichever comes first	Yes
Secondary	Patient safety event	Any Type 2 diagnostic code for a patient-safety event as described by Southern et al, Medical Care 2016	surgery to hospital discharge, or up to 365 days after surgery	Yes
Secondary	Hospital length of stay		date of surgery to date of hospital discharge, or 365 days after surgery, whichever comes first	No
Secondary	Non-independent discharge location	Discharge disposition from hospital record that is not a home discharge without support	date of surgery to date of hospital discharge, or 365 days after surgery, whichever comes first	No
Secondary	30-day hospital readmission	New acute care hospitalization within 30-days of discharge from the index hospitalization	date of discharge to 30 days after discharge	No
Secondary	Health Utility Index	A health utility index will be constructed, and used as an outcome if an adequate number of participants have required measures to support multivariable modelling	in the 365 days following surgery	No