Effects of a modified Hospital Elder Life Program on frailty in individuals undergoing major elective abdominal surgery
Authors
Chen, Cheryl Chia-HuiChen, Chiung-Nien
Lai, I-Rue
Huang, Guan-Hua
Saczynski, Jane S.
Inouye, Sharon K.
UMass Chan Affiliations
Meyers Primary Care InstituteDepartment of Medicine, Division of Geriatric Medicine
Document Type
Journal ArticlePublication Date
2014-02-01Keywords
Abdomen*Activities of Daily Living
Aged
Female
Frail Elderly
Geriatric Assessment
Hospitalization
Humans
Male
Odds Ratio
Postoperative Care
Postoperative Complications
*Surgical Procedures, Elective
Taiwan
Geriatrics
Health Services Administration
Surgery
Metadata
Show full item recordAbstract
OBJECTIVES: To test the effects of a modified Hospital Elder Life Program (mHELP) on frailty. DESIGN: Matched and unmatched analyses of data from a before-and-after study. SETTING: Hospital, inpatient. PARTICIPANTS: Participants aged 65 and older (n = 189) undergoing major elective abdominal surgery at a medical center in Taiwan. INTERVENTION: The mHELP included three nursing interventions: early mobilization, oral and nutritional assistance, and orienting communication. MEASUREMENTS: Frailty rate and transitions between frailty states from hospital discharge to 3 months after discharge using Fried's phenotype criteria categorized as nonfrail (0 or 1 criteria present), prefrail (2 or 3 criteria present), and frail (4 or 5 criteria present). RESULTS: In matched pairs, participants who received the mHELP interventions were significantly less likely to be frail at discharge (19.2%) than matched controls (65.4%) (adjusted odds ratio (AOR) = 0.10, 95% CI = 0.02-0.39). Transitions to states of greater frailty during hospitalization were more common for participants in the control group. Three months after discharge, participants who received the mHELP intervention during hospitalization were less likely to be frail (17.3%) than matched controls (23.1%) (AOR = 0.73, 95% CI = 0.21-2.56), although this difference did not achieve statistical significance. CONCLUSION: The mHELP intervention is effective in reducing frailty by hospital discharge, but the benefit is diminished by 3 months after discharge. Thus, the mHELP provides a useful approach to manage in-hospital frailty for older adults undergoing major abdominal surgery. Geriatrics Society.Source
J Am Geriatr Soc. 2014 Feb;62(2):261-8. doi: 10.1111/jgs.12651. Link to article on publisher's siteDOI
10.1111/jgs.12651Permanent Link to this Item
http://hdl.handle.net/20.500.14038/37289PubMed ID
24437990Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/jgs.12651