title: Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients.
abstract: BACKGROUND
  The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.
  
  
  METHODS
  A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL) functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.
  
  
  RESULTS
  Data of 260 patients (intervention n = 127, Control n = 133) were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88), an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87) and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49).
  
  
  CONCLUSIONS
  A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.
  
  
  BACKGROUND
  Nederlands Trial Register, Trial ID NTR 823.
authors.affiliation: University Center for Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.|Geriatric Center, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Hempenius
authors.affiliation: University Center for Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Joris P J
authors.initials: JP
authors.lastname: Slaets
authors.affiliation: Department of Geriatrics, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Dieneke
authors.initials: D
authors.lastname: van Asselt
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Truuske H
authors.initials: TH
authors.lastname: de Bock
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: Wiggers
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: van Leeuwen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D007902:Length of Stay; D008297:Male; D009369:Neoplasms; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors