Elderly man awaits surgery

Care of Older People in Surgery

Each year the number of older people undergoing surgery increases. Although evidence is well established that older age and frailty are associated with greater risk of poorer postoperative outcomes, there is little evidence to date to establish whether outcomes can be improved through geriatric intervention. Even less is known about what proportion of this population have dementia or are from CALD backgrounds, nor how their care may also be improved.
To date research into the care of older surgical patients has been largely limited to orthopaedic patients, in particular those with hip fractures. There is a substantial body of evidence to suggest that orthopaedic surgeons and geriatricians working collaboratively can improve patient outcomes including improved mortality and decreased length of stay, when geriatric care is delivered comprehensively, as part of a cooperative or shared model of care. This has led to the adoption of combined orthogeriatric services being adopted widely, both on a national and international level.
This project will describe the older non-orthopaedic surgical patient population and their journey in the acute setting. It will allow us to identify opportunities to enhance care and improve outcomes with a view to the development, implementation and evaluation of a complex intervention, involving a shared model of care between surgeons and geriatricians, at The Prince of Wales Hospital (POWH).