scholarly journals Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia

2020 ◽  
Author(s):  
Ross P Martini ◽  
N David Yanez ◽  
Miriam Treggiari ◽  
Praveen Tekkali ◽  
Cobin Soelberg ◽  
...  
Keyword(s):  
High Risk ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
A Priori ◽  
Interrupted Time Series ◽  
Patient Characteristics ◽  
Surgical Patients ◽  
Postoperative Pneumonia ◽  
Improvement Project ◽  
Significant Difference

Abstract Background : Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation. Methods : We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia. Results : 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010). Conclusions : The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery. ClinicalTrials.gov ID NCT02450929

scholarly journals Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia

2020 ◽  
Author(s):  
Ross P Martini ◽  
N Daid Yanez ◽  
Miriam Treggiari ◽  
Praveen Tekkali ◽  
Cobin Soelberg ◽  
...  
Keyword(s):  
High Risk ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
A Priori ◽  
Interrupted Time Series ◽  
Patient Characteristics ◽  
Surgical Patients ◽  
Postoperative Pneumonia ◽  
Improvement Project ◽  
Significant Difference

Abstract Background: Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.Methods: We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.Results: 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010).Conclusions: The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery. ClinicalTrials.gov ID NCT02450929

scholarly journals Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia

2020 ◽  
Author(s):  
Ross P Martini ◽  
N David Yanez ◽  
Miriam Treggiari ◽  
Praveen Tekkali ◽  
Cobin Soelberg ◽  
...  
Keyword(s):  
High Risk ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
A Priori ◽  
Interrupted Time Series ◽  
Patient Characteristics ◽  
Surgical Patients ◽  
Postoperative Pneumonia ◽  
Improvement Project ◽  
Significant Difference

Abstract Background: Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.Methods: We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.Results: 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010).Conclusions: The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery. ClinicalTrials.gov ID NCT02450929

scholarly journals Prevention of Postoperative Pneumonia in Noncardiac Surgical Patients: A Prospective Study Using the National Surgical Quality Improvement Program Database

2019 ◽  
Vol 85 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Michael L. Caparelli ◽  
Alexander Shikhman ◽  
Abdullah Jalal ◽  
Sandra Oppelt ◽  
Cari Ogg ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Confidence Interval ◽  
Current Data ◽  
Surgical Patients ◽  
Postoperative Pneumonia ◽  
Care Bundle ◽  
Successful Implementation ◽  
Improvement Program ◽  
Improvement Project ◽  
Significant Difference

Postoperative pneumonia increases morbidity, length of stay, and hospital readmission rates. Current data support the use of perioperative chlorhexidine gluconate in elective cardiac surgery patients to prevent postoperative pneumonia. The objectives of this study were to implement a resident-driven quality improvement project and determine the efficacy of an oral care bundle in preventing postoperative pneumonia among noncardiac surgical patients. A retrospective review of postoperative pneumonia occurrences at our hospital captured by the NSQIP database from 2014 to 2016 was conducted. A pre- and postoperative pulmonary care bundle was implemented in all surgical patients undergoing general anesthesia and outcomes were tracked by NSQIP for up to 90 days postoperatively for calendar year 2017. The NSQIP-reported incidence of postoperative pneumonia at our hospital was reduced from 0.8 to 0 per cent (P = 0). The risk-adjusted smoothed rate fell from 1.17 (95% confidence interval 0.77–1.66) in 2014 to 0.33 (95% confidence interval 0.03–0.98) in 2017. We encountered multiple systematic issues while conducting this study, which led to an imbalanced compliance to the preoperative (90%) and postoperative (31%) bundle; however, there was no significant difference between these two groups. Successful implementation of a resident-driven quality project resulted in a decreased rate of postoperative pneumonia.

Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria

2017 ◽  
Vol 27 (4) ◽  
pp. 271-278 ◽  
Author(s):  
Lakshmi Swaminathan ◽  
Scott Flanders ◽  
Mary Rogers ◽  
Yvonne Calleja ◽  
Ashley Snyder ◽  
...  
Keyword(s):  
Time Series ◽  
Clinical Care ◽  
Interrupted Time Series ◽  
Patient Characteristics ◽  
Absolute Difference ◽  
Improvement Project ◽  
Multimodal Intervention ◽  
Hospitalised Patients ◽  
Quasi Experimental ◽  
Future Work

BackgroundAlthough important in clinical care, reports of inappropriate peripherally inserted central catheter (PICC) use are growing.ObjectiveTo test whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve PICC use and patient outcomes.DesignQuasi-experimental, interrupted time series design at one study site with nine contemporaneous external controls.SettingTen hospitals participating in a state-wide quality collaborative from 1 August 2014 to 31 July 2016.Patients963 hospitalised patients who received a PICC at the study site vs 6613 patients at nine control sites.InterventionA multimodal intervention (tool, training, electronic changes, education) derived from MAGIC.MeasurementsAppropriateness of PICC use and rates of PICC-associated complications. Segmented Poisson regression was used for analyses.ResultsAbsolute rates of inappropriate PICC use decreased substantially at the study site versus controls (91.3% to 65.3% (−26.0%) vs 72.2% to 69.6% (−2.6%); P<0.001). After adjusting for underlying trends and patient characteristics, however, a marginally significant 13.8% decrease in inappropriate PICC use occurred at the study site (incidence rate ratio 0.86 (95% CI 0.74 to 0.99; P=0.048)); no change was observed at control sites. While the incidence of all PICC complications decreased to a greater extent at the study site, the absolute difference between controls and intervention was small (33.9% to 26.7% (−7.2%) vs 22.4% to 20.8% (−1.6%); P=0.036).LimitationsNon-randomised design limits inference; the most effective component of the multimodal intervention is unknown; effects following implementation were modest.ConclusionsIn a multihospital quality improvement project, implementation of MAGIC improved PICC appropriateness and reduced complications to a modest extent. Given the size and resources required for this study, future work should consider cost-to-benefit ratio of similar approaches.

scholarly journals P-EGS04 Assessment of Malnutrition in emergency laparotomy patients. A QIP highlighting simple measures can improve early recognition and optimisation of high-risk patients

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Charef Raslan ◽  
Omar Lasheen ◽  
Feras Tomalieh ◽  
Khurram Siddique
Keyword(s):  
High Risk ◽  
Nursing Staff ◽  
Early Recognition ◽  
Emergency Laparotomy ◽  
Second Phase ◽  
Team Approach ◽  
Medical Team ◽  
Improvement Project ◽  
Significant Difference ◽  
Online Calculator

Abstract Background Early recognition of high-risk malnourished patients is important for optimisation of nutritional status leading to better outcomes.  The accurate recording of malnutrition universal screening tool (MUST) results is vital in this regard. This quality improvement project (QIP) aimed to review the quality of nutritional assessment of emergency laparotomy patients against the National Institute for Health and Care Excellence (NICE) guidelines and outline area of improvement. Methods The QIP was conducted at Royal Oldham Hospital in 2019-2020 over a seven-month period.  Fifty random patients were included in the first audit cycle over a 4-month period, followed by implementation of recommended changes and a re-audit of 30 patients over a 2-month period.  The initial MUST scores which were calculated and documented by nursing staff were identified as the nursing staff MUST score (NSMS). To assess the accuracy of NSMS, we developed a MUST rescoring method which was performed by a senior member of the medical team and was identified as the medical team MUST rescore (MTMR).  Results The initial audit showed a significant difference between NSMS and MTMR scores. According to MTMR, 23 patients (46%) had an inaccurate MUST score assessment by the nursing staff.  A multidisciplinary approach using a standard online calculator were recommended.  The second phase of the QIP showed an obvious improvement in the accuracy of MUST assessment. Our interventions improved the accuracy rate of MUST scores significantly (27, 54% vs 29, 96.6%, P = 0.00005). Conclusions A multidisciplinary team approach and online calculator are useful in improving the accuracy of MUST assessment in emergency laparotomy patients. This helped early involvement of the dietitian leading to improvement in morbidity and mortality. 

Antibacterial Properties and Application of Nanosilver Material in the Tracheal Tube

2020 ◽  
Vol 20 (10) ◽  
pp. 6542-6546
Author(s):  
Yunjie Hu ◽  
Xiaobei Ji ◽  
Dunshuang Wei ◽  
Jun Deng
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Tracheal Tube ◽  
Antibacterial Properties ◽  
Plate Count ◽  
Control Group ◽  
Significant Difference ◽  
New Type ◽  
Experimental Group

To investigate the antibacterial ability of a new type of antibacterial tracheal tube coated with nanosilver/polyurethane in rats. In January 2016, 48 male SD rats of SPF grade, provided by the medical center of Hong Kong University of science and technology, Peking University, Shenzhen, were selected as the study objects. Twenty-four healthy rats, who underwent endotracheal intubation and retained nanosilver/polyurethane-coated new antibacterial endotracheal tube in vivo, were randomly selected as the experimental group, while 24 healthy rats who underwent endotracheal intubation at the same time and retained common endotracheal tube in vivo were randomly selected as the control group. At 12, 24, 48, and 72 hours after the operation, the number of colonies in the alveolar lavage fluid of the two groups was measured using the plate count method, and the thickness of the biofilm formed by the built-in catheter of the two groups was observed by microscope. Twelve hours after operation, there was no significant difference between the two groups (P <0.05). The colony number in BALF in the experimental group was significantly lower than that in the control group (P < 0.05). At 12 and 24 hours after operation, there was no significant difference in the biofilm thickness between the two groups (P > 0.05). In the experimental group, the thickness of biofilm that had formed by catheterization 48 and 72 hours after operation was significantly lower than that in the control group (P < 0.05). The new type of antibacterial tracheal tube, coated with nanosilver/polyurethane, has stronger antibacterial and anti-biofilm proliferation performance than that of the common tracheal tube.

scholarly journals Uncuffed Endotracheal Tube Experience in Pediatric Patients with Laparotomy and Laparoscopic Surgeries

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sema Şanal Baş ◽  
Gülay Erdoğan Kayhan ◽  
Meryem Onay ◽  
Yeliz Kılıç
Keyword(s):  
Mechanical Ventilation ◽  
Side Effects ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Pediatric Patients ◽  
Mechanical Parameters ◽  
Significant Difference ◽  
Tube Exchange ◽  
Endotracheal Tube Size ◽  
Selection Of

Aim. The aim of this study is to compare endotracheal tube leak, tube selection, mechanical ventilation, and side effects in the use of uncuffed tubes in both laparoscopic and laparotomy surgeries in pediatric patients. Material and Method. Patients who underwent laparotomy (LT group) or laparoscopic (LS group) surgery between 1 and 60 months. In the selection of uncuffed tubes, it was also planned to start endotracheal intubation with the largest uncuffed tube and to start intubation with a small uncuffed tube if the tube encounters resistance and does not pass. Mechanical parameters, endotracheal tube size, tube changes, and side effects are recorded. Results. A total of 102 patients, 38 females and 64 males, with a mean age of 10.9±8.1 months, body weight 7.1±3.7 kg, and height 67±15 cm, were included. 54 patients underwent laparoscopic surgery, and 48 patients underwent laparotomy. Tube exchange was performed in a total of 18 patients. In patients who underwent tube exchange, 11 patients were intubated with a smaller ETT number and others endotracheal intubation; when the MV parameters were TVe<8 ml/kg and ETT leak>20%, a larger uncuffed tube was used due to PIP 30 cmH2O pressure. Patients with aspiration were not found in the LT and LS groups. There was no difference in the intergroup evaluation for postoperative side effects such as cough, laryngospasm, stridor, and aspiration. Conclusion. There was no significant difference between the groups in terms of tube changes and side effects. So that we can start with the largest possible uncuffed tube to decrease ETT leak, both laparotomy and laparoscopic operations in children can be achieved with safe mechanical ventilation and target tidal volume.

scholarly journals Betamethasone Gel versus Intravenous Dexamethasone as Prophylaxis against Postoperative Sore Throat

2018 ◽  
Vol 6 (2) ◽  
pp. 73-77 ◽  
Author(s):  
Muhammad Sazzad Hossain ◽  
Mamunur Rashid ◽  
Anisur Rahman Babu ◽  
Devashis Saha ◽  
Debasish Banik
Keyword(s):  
Endotracheal Tube ◽  
General Anaesthesia ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Lower Incidence ◽  
Control Group ◽  
Postoperative Sore Throat ◽  
Dexamethasone Group ◽  
Significant Difference ◽  
And Control

Background: Postoperative sore throat (POST) though a minor sequel after general anaesthesia with endotracheal intubation, it can be distressing to the patient.Objective: The effectiveness of lubricating endotracheal tube with 0.05% betamethasone gel or intravenous dexamethasone in reducing the postoperative sore throat was compared.Materials and method: This was a prospective study carried out among ninety ASA I and II informed consenting patients aged 20-50 years undergoing elective surgery under general anaesthesia with endotracheal intubation. The patients were randomly divided into three groups with thirty subjects in each group. Betamethasone gel (0.05%) was applied over endotracheal tube over 15 cm mark from the tip in group I, intravenous dexamethasone was given in group II and group III was taken as control. In post-anaesthesia care unit, an anesthesiologist interviewed all patients on postoperative sore throat at 1 hour, 6 hours and 24 hours after operation.Results: At 24 hours following extubation, there was statistically significant lower incidence of post-operative sore throat (POST) in betamethasone group compared to other two groups (betamethasone group 3.33%, dexamethasone group 20% and control group 26.66%, p<0.05). When the groups were compared in pairs at 24 hours, there was statistically significant difference in the incidence of POST between betamethasone group and dexamethasone group and also betamethasone group and control group with lower incidence of POST in betamethasone group, p<0.05. It was also observed that there was no significant difference of POST between dexamethasone and control group at 1 hour, 6 hours or 24 hours, p>0.05.Conclusion: It can be concluded that the use of 0.05% betamethasone gel to lubricate widely the endotracheal tube prior to intubation effectively reduces postoperative sore throat, compared to intravenous dexamethasone administration.Delta Med Col J. Jan 2018 6(2): 73-77

scholarly journals Assessment of Malnutrition in Emergency Laparotomy Patients. A QIP Highlights Simple Measures To Improve Early Recognition and Optimisation of High-Risk Patients.

2021 ◽  
Author(s):  
Charef Raslan ◽  
Feras Tomalieh ◽  
Omar Lasheen ◽  
Khurram Siddique
Keyword(s):  
High Risk ◽  
Nursing Staff ◽  
Early Recognition ◽  
Emergency Laparotomy ◽  
Second Phase ◽  
Team Approach ◽  
Medical Team ◽  
Improvement Project ◽  
Significant Difference ◽  
Online Calculator

Abstract Aim Early recognition of high-risk malnourished patients is important for optimisation of nutritional status leading to better outcomes. The accurate recording of malnutrition universal screening tool (MUST) results is vital in this regard. This quality improvement project (QIP) aimed to review the quality of nutritional assessment of emergency laparotomy patients against the National Institute for Health and Care Excellence (NICE) guidelines and outline area of improvement.Method The QIP was conducted at Royal Oldham Hospital in 2019-2020 over a seven-month period. Fifty random patients were included in the first audit cycle over a 4-month period, followed by implementation of recommended changes and a re-audit of 30 patients over a 2-month period. The initial MUST scores which were calculated and documented by nursing staff were identified as the nursing staff MUST score (NSMS). To assess the accuracy of NSMS, we developed a MUST rescoring method which was performed by a senior member of the medical team and was identified as the medical team MUST rescore (MTMR). Results The initial audit showed a significant difference between NSMS and MTMR scores. According to MTMR, 23 patients (46%) had an inaccurate MUST score assessment by the nursing staff. A multidisciplinary approach using a standard online calculator were recommended. The second phase of the QIP showed an obvious improvement in the accuracy of MUST assessment. Our interventions improved the accuracy rate of MUST scores significantly (27, 54% vs 29, 96.6%, P = 0.00005).Conclusion A multidisciplinary team approach and online calculator are useful in improving the accuracy of MUST assessment in emergency laparotomy patients. This helped early involvement of the dietitian leading to improvement in morbidity and mortality.

scholarly journals Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aparna Saripella ◽  
Sara Wasef ◽  
Mahesh Nagappa ◽  
Sheila Riazi ◽  
Marina Englesakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Meta Analysis ◽  
Geriatric Care ◽  
Surgical Patients ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Care Models ◽  
Comprehensive Geriatric Care

Abstract Background The elderly population is highly susceptible to develop post-operative complications after major surgeries. It is not clear whether the comprehensive geriatric care models are effective in reducing adverse events. The objective of this systematic review and meta-analysis is to determine whether the comprehensive geriatric care models improved clinical outcomes, particularly in decreasing the prevalence of delirium and length of hospital stay (LOS) in elderly surgical patients. Method We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and ICTRP between 2009 to January 23, 2020. We included studies on geriatric care models in elderly patients (≥60 years) undergoing elective, non-cardiac high-risk surgery. The outcomes were the prevalence of delirium, LOS, rates of 30-days readmission, and 30-days mortality. We used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds Ratio (OR) and Mean Difference (MD) using random effect model analysis. Results Eleven studies were included with 2672 patients [Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials (Non-RCTs): 7]. Data pooled from six studies showed that there was no significant difference in the prevalence of delirium between the intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI: 0.30–1.96; p = 0.57). Similarly, there were no significant differences in the LOS (MD: -0.55; 95% CI: − 2.28, 1.18; p = 0.53), 30-day readmission (12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67–1.77; p = 0.73), and 30-day mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66–2.69; p = 0.42). The quality of evidence was very low. Conclusions The geriatric care models involved pre-operative comprehensive geriatric assessment, and intervention tools to address cognition, frailty, and functional status. In non-cardiac high-risk surgeries, these care models did not show any significant difference in the prevalence of delirium, LOS, 30-days readmission rates, and 30-day mortality in geriatric patients. Further RCTs are warranted to evaluate these models on the postoperative outcomes. Trial registration PROSPERO registration number - CRD42020181779.

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