Implementing the American College of Surgeons (ACS) Geriatric Surgery Verification program may help to improve postoperative outcomes and preserve independence in older patients with cancer undergoing major abdominal procedures, according to a recent study published by Jimenez et al in the Journal of the American College of Surgeons.
“Older patients comprise an increasingly large share of surgical oncology cases and represent a group with unique needs and goals,” explained co–study author Ponnandai Somasundar, MD, FACS, Associate Professor of Surgery at Boston University as well as Chief of Surgical Oncology and Director of Geriatric Surgery at the Roger Williams Medical Center. “It’s important to assess outcomes these patients value such as being discharged to home and maintaining independence after surgery,” he added.
Study Methods and Results
In this study, researchers evaluated the impact of the Geriatric Surgery Verification program among patients aged 65 and older with cancer who were undergoing major abdominal oncologic operations at a community hospital. They compared the outcomes of 43 patients treated following the implementation of the Geriatric Surgery Verification program with those of 57 patients treated prior to the program’s implementation. The researchers tracked multiple short-term outcomes, including length of hospital stay and where the patient was going to live after discharge.
The researchers found that with the Geriatric Surgery Verification program in effect, patients’ average length of hospital stay was shorter compared with hospital stays prior to the program’s implementation (4.4 vs 6.5 days, respectively). Just 7.3% of the patients in the intervention group were newly discharged to a care institution rather than to their primary residence compared with 24.1% of those in the control group. Additionally, the Geriatric Surgery Verification program’s implementation was associated with a 72% reduced risk of increased care needs at discharge, indicating higher levels of patient independence.
Critical components of the Geriatric Surgery Verification program that may have contributed to these improved outcomes included comprehensive assessments, personalized care plans, prehabilitation, and strategies to mitigate postoperative risks (such as delirium and falls).
Conclusions
“Our study demonstrates that implementing the [Geriatric Surgery Verification] program not only reduces how long patients stay in the hospital but also helps maintain the independence that is so crucial to our older patients,” highlighted senior study author Steve (Sung) Kwon, MD, MPH, FACS, a surgical oncologist at the Roger Williams Medical Center and Director of the Roger Williams Surgery and Cancer Outcomes Research and Equity center. “An [initiative] like [the Geriatric Surgery Verification program] helps to prepare and manage older [patients with] cancer perioperatively, addressing their specific needs and improving their overall quality of life,” he indicated.
“Most cancer care is delivered in community hospitals. By implementing programs like [Geriatric Surgery Verification], we can improve the quality of care and outcomes for older [patients with] cancer where they receive their care,” Dr. Somasundar stated.
The researchers underscored the significance and feasibility of adopting the Geriatric Surgery Verification program in community hospital settings. Despite the positive findings, further studies may be needed to explore the long-term patient outcomes as well as to determine which aspects of the Geriatric Surgery Verification program may lead to these improved outcomes.
“We’re keeping track of patients’ outcomes regarding their long-term independence,” underlined Dr. Kwon. “More research will help us understand the full benefits of the [Geriatric Surgery Verification] program for this vulnerable population,” he concluded.
Disclosure: For full disclosures of the study authors, visit journals.lww.com.
