Authors (including presenting author) :
Chan PC(1), Tang YCF(1), Lee WMC(1), Wong CCA(1), Ng YMT(2), Law TC(2), Luk KHJ(2), Chan KKS(1), Leung MY(3), Lam YHR(4)
Affiliation :
(1)Department of Surgery, QMH, (2)Department of Medicine, FYKH, (3)Department of Anaesthesia, Pain and Perioperative Medicine,(4) Patient Resource Centre
Introduction :
Owing to longevity and better medical care, operations in the geriatric population is increasing. Geriatric patients often face unique challenges when they undergo surgical procedures, particularly in the field of vascular surgery. These potential challenges may include cognitive impairment, delirium, functional decline and postoperative medical complications. A pilot program in geriatric vascular surgery collaboration service was implemented to improve the quality and standard of care for elderly patients requiring vascular interventions.
Objectives :
This involves bringing together a multidisciplinary team to provide comprehensive geriatric assessment and patient care service coordination. It aims to improve patient surgical outcomes, decrease geriatric complications and enhance the overall experience of geriatric patients undergoing vascular surgery.
Methodology :
Patients aged ≥65y who undergo elective surgery for peripheral vascular disease with lower limb tissue loss are recruited for this program. Besides, patients with 5Ds criteria (Dementia, Delirium, Depression, Drug or Discharge problems) are referred to geriatric team for review before operation. The following outcomes are measured in the program: delirium (post-operative phase), newly developed pressure injury, hospital-acquired pneumonia, UTI, and unplanned 30-day readmission. Also, a questionnaire was given to patients or relatives for their feedback.
Result & Outcome :
From April to December 2023, four female and three male patients with a mean age of 82.7 were recruited. 28.7% patients (n=2) have unplanned 30-day readmissions. 14.2% patients (n=1) developed post-op delirium. None of them had newly developed pressure injury, hospital-acquired pneumonia or UTI. All patients and their relatives were satisfied with the patient journey on geriatric vascular surgery collaboration service. Conclusion: The majority of vascular patients are elderly and present a unique set of problems after the operation. They require special attention with regard to preoperative optimization of comorbid conditions, careful intraoperative monitoring and watchful postoperative management. The introduction of geriatric vascular surgery collaboration service will usher in clinical and professional enhancements in the vascular service. The way forward is to broaden the inclusion criteria to encompass other vascular diseases, which could allow a more comprehensive approach to addressing the healthcare needs in elderly population.
