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Related Experiment Videos

Preoperative Risk Assessment and Shared Decision-Making in Older Patients Eligible for Cardiac Surgery: Protocol for

Milou S H van Dieën1,2, Fredrike Blokzijl2,3, Michiel Kuijpers3

  • 1Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands.

Healthcare (Basel, Switzerland)
|July 15, 2026
PubMed
Summary

A new nurse-led clinic (PRIME) improves treatment recommendations for frail older adults undergoing cardiac surgery by integrating geriatric assessments and shared decision-making, enhancing patient-centered care.

Keywords:
cardiac surgical proceduresclinical trial protocoldecision-makingfrail elderlynursingquality of lifeshared

Related Experiment Videos

Area of Science:

  • Geriatric Medicine
  • Cardiothoracic Surgery
  • Health Services Research

Background:

  • Increasing number of frail older adults undergoing cardiac surgery.
  • Frailty is linked to adverse outcomes and complicates treatment decisions.
  • Current Heart Team recommendations primarily focus on disease parameters.

Purpose of the Study:

  • Evaluate the impact of a nurse-led preoperative pathway (PRIME clinic) on Heart Team treatment recommendations.
  • Assess the cost-effectiveness of the PRIME clinic.
  • Integrate patient preferences and shared decision-making into cardiac surgical practice.

Main Methods:

  • Single-center, non-randomized prospective study in the Netherlands.
  • Inclusion of patients aged ≥70 years with cardiac surgery eligibility and ≥2 adverse outcome risk factors.
  • Intervention group receives PRIME clinic consultation (geriatric assessment, shared decision-making) before Heart Team re-evaluation.

Main Results:

  • Primary outcome: Comparison of initial vs. subsequent Heart Team treatment recommendations.
  • Secondary outcomes: Health-related quality of life and cost-effectiveness.
  • Exploratory analysis of a novel patient-centered preoperative care model.

Conclusions:

  • The PRIME study evaluates a patient-centered model for older adults undergoing cardiac surgery.
  • Focuses on integrating geriatric assessment and shared decision-making.
  • Aims to advance value-based, individualized surgical care for older patients.