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Patient reported outcomes in an elder-friendly surgical environment: Prospective, controlled before-after study.

Bianka Saravana-Bawan1, Lindsey M Warkentin1, Arto Ohinmaa2

  • 1Department of Surgery, University of Alberta, Walter C Mackenzie Health Sciences Centre, 8440 112 Street, Edmonton, AB, T6G 2B7, Canada.

Annals of Medicine and Surgery (2012)
|May 24, 2021
PubMed
Summary

The Elder-friendly Approaches to the Surgical Environment (EASE) study found that implementing an ACE unit on surgical services did not negatively impact elderly patients' quality of life or satisfaction post-discharge. These findings suggest EASE interventions are safe for patient-reported outcomes.

Keywords:
ACE modelElderlyEmergency surgeryNutritionPatient reported outcomesQuality of life

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Area of Science:

  • Geriatric Medicine
  • Surgical Care
  • Health Services Research

Background:

  • The Acute Care for the Elderly (ACE) model shows clinical benefits, but its impact on post-discharge quality of life is understudied.
  • The Elder-friendly Approaches to the Surgical Environment (EASE) study assessed ACE unit implementation in acute surgical care.
  • Previous EASE research highlighted clinical and economic improvements, but patient-reported outcomes after discharge were not yet analyzed.

Purpose of the Study:

  • To evaluate the post-discharge quality of life, malnutrition risk, and patient satisfaction in elderly surgical patients following EASE intervention.
  • To assess the impact of an ACE unit on patient-reported outcomes 6 weeks and 6 months after discharge.

Main Methods:

  • A prospective, concurrently controlled, before-after study was conducted at two tertiary care hospitals in Alberta, Canada.
  • Elderly patients (≥ 65 years) completed SF-12, EQ-5D, Canadian Malnutrition Screening Tool (CMST), and patient satisfaction surveys.
  • A difference-in-difference (DID) analysis was employed to compare between-site effects.

Main Results:

  • Patient satisfaction was high (68%-86%) at six weeks, with significant improvement at the control site post-intervention.
  • Within-site analyses showed non-significant effects for most patient-reported outcomes at the intervention site.
  • DID analyses revealed non-significant differences for most outcomes, except for the SF-12 Mental Component Score.

Conclusions:

  • EASE interventions, while clinically and economically beneficial, do not appear to negatively affect post-discharge quality of life, malnutrition risk, or patient satisfaction.
  • Further research with larger sample sizes is recommended to confirm these findings and explore comparisons with pre-intervention and early post-discharge periods.