Application of comprehensive geriatric assessment in the management of elderly patients undergoing daytime surgery_West China Medical Journal

Authors：

 NI Ruyang ¹ , WANG Jing ² , LUO Changchun ³ , WANG Huimin ³ , BI Jing ³

1. Hospital Office, Beijing Geriatric Hospital, Beijing 100095, P. R. China;
2. Medical Office, Beijing Geriatric Hospital, Beijing 100095, P. R. China;
3. Nursing Department, Beijing Geriatric Hospital, Beijing 100095, P. R. China;

Corresponding author：

NI Ruyang, Email: niruyang@126.com

Keywords：

Comprehensive geriatric assessment; daytime surgery; whole process management; elderly

DOI：

10.7507/1002-0179.202412004

Video：

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Objective To explore the effect of comprehensive geriatric assessment on the whole process management of elderly patients undergoing daytime surgery. Methods Elderly patients undergoing daytime surgery at Beijing Geriatric Hospital between April and September 2024 were included and randomly divided into a control group and a trial group using a random number table method. The control group received routine care for the whole process of daytime surgery, while the trial group received daytime surgery routine care, comprehensive geriatric assessment and corresponding intervention measures. The basic information, delayed discharge, adverse events of daytime surgery, and patient satisfaction of the two groups of patients were compared. Results A total of 84 elderly patients were ultimately included, with 42 in the trial group and 42 in the control group. There was no statistically significant difference in age, gender, number of comorbidities, number of oral medications, American Society of Anesthesiology anesthesia grading, and daytime surgical procedures between the two groups of patients (P>0.05). The incidence of postoperative adverse events in the trial group was lower than that in the control group (11.90% vs. 30.95%), and the patient satisfaction rate was higher than that in the control group (100.00% vs. 85.71%), with statistically significant differences (P<0.05). There was no statistically significant difference in the delayed discharge rate between the two groups (P>0.05). Conclusion For elderly patients undergoing daytime surgery, embedding comprehensive geriatric assessment in the whole process management can reduce postoperative adverse events and improve patient satisfaction, which is worth promoting.

Citation： NI Ruyang, WANG Jing, LUO Changchun, WANG Huimin, BI Jing. Application of comprehensive geriatric assessment in the management of elderly patients undergoing daytime surgery. West China Medical Journal, 2025, 40(2): 256-260. doi: 10.7507/1002-0179.202412004 Copy

1.	孙博, 刘雷, 王东光. 国内日间手术发展进程、存在问题与对策建议. 中国卫生质量管理, 2018, 25(5): 17-20.
2.	张继东, 闻大翔, 骆华杰, 等. 日间医疗的实践探索与思考. 中华医院管理杂志, 2017, 33(5): 345-348.
3.	马洪升. 日间手术的管理. 华西医学, 2017, 32(4): 481-482.
4.	Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
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6.	沈蓝君, 夏露, 彭健, 等. 老年日间手术患者延续护理需求质性研究. 中国初级卫生保健, 2022, 36(6): 114-117.
7.	鲁世保. 高龄患者脊柱手术面临的困境与挑战. 中国骨与关节杂志, 2022, 11(11): 801-803.
8.	陈旭娇, 严静, 王建业, 等. 老年综合评估技术应用中国专家共识. 中华老年医学杂志, 2017, 36(5): 471-477.
9.	殷琪, 何扬利, 孙翠芳, 等. 多维度综合诊疗方案在老年慢性病治疗中的应用. 中国老年学杂志, 2021, 41(5): 1031-1033.
10.	吴敏婕, 吴申慧, 严玉茹. 老年综合评估在老年衰弱群体中的应用现状及思考. 中国全科医学, 2023, 26(13): 1655-1660.
11.	周亮, 徐海涛, 刘佐忠, 等. 快速康复外科理念和老年综合评估在高龄骨质疏松性椎体压缩性骨折患者椎体成形术围手术期管理的临床应用. 脊柱外科杂志, 2024, 22(5): 308-312.
12.	刘彩云, 霍晓鹏, 刘晓萱, 等. 基于老年综合评估的预康复在术前衰弱老年肺癌病人中的应用. 实用老年医学, 2024, 38(11): 1153-1157.
13.	Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J, 1965, 14: 61-65.
14.	Balducci L, Stanta G. Cancer in the frail patient. A coming epidemic. Hematol Oncol Clin North Am, 2000, 14(1): 235-250.
15.	Chu JJ, Chen XJ, Shen SS, et al. A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension: a cross-sectional study. J Geriatr Cardiol, 2015, 12(2): 113-118.
16.	Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res, 1982, 17(1): 37-49.
17.	Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975, 12(3): 189-198.
18.	Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
19.	Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
20.	Jebb AT, Ng V, Tay L. A review of key likert scale development advances: 1995-2019. Front Psychol, 2021, 12: 637547.
21.	孙立, 陈杰, 申英末. 老年腹股沟疝日间手术注意事项. 中国实用外科杂志, 2018, 38(8): 873-876.
22.	邹妮, 王丹, 傅晟静, 等. 老年患者日间手术全程质量管理模式研究. 中国卫生质量管理, 2022, 29(1): 33-36.
23.	张倩, 张福霞. 我国老年综合评估领域文献的可视化分析. 医学信息, 2024, 37(17): 41-46.
24.	Dworsky JQ, Castle SC, Lee CC, et al. Gerofit prehabilitation pilot program: preparing frail older veterans for surgery. J Healthc Qual, 2019, 41(2): 91-98.

1. 孙博, 刘雷, 王东光. 国内日间手术发展进程、存在问题与对策建议. 中国卫生质量管理, 2018, 25(5): 17-20.
2. 张继东, 闻大翔, 骆华杰, 等. 日间医疗的实践探索与思考. 中华医院管理杂志, 2017, 33(5): 345-348.
3. 马洪升. 日间手术的管理. 华西医学, 2017, 32(4): 481-482.
4. Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
5. 焦雅辉. 中国日间手术发展报告(2020). 北京: 北京大学医学出版社, 2020: 1.
6. 沈蓝君, 夏露, 彭健, 等. 老年日间手术患者延续护理需求质性研究. 中国初级卫生保健, 2022, 36(6): 114-117.
7. 鲁世保. 高龄患者脊柱手术面临的困境与挑战. 中国骨与关节杂志, 2022, 11(11): 801-803.
8. 陈旭娇, 严静, 王建业, 等. 老年综合评估技术应用中国专家共识. 中华老年医学杂志, 2017, 36(5): 471-477.
9. 殷琪, 何扬利, 孙翠芳, 等. 多维度综合诊疗方案在老年慢性病治疗中的应用. 中国老年学杂志, 2021, 41(5): 1031-1033.
10. 吴敏婕, 吴申慧, 严玉茹. 老年综合评估在老年衰弱群体中的应用现状及思考. 中国全科医学, 2023, 26(13): 1655-1660.
11. 周亮, 徐海涛, 刘佐忠, 等. 快速康复外科理念和老年综合评估在高龄骨质疏松性椎体压缩性骨折患者椎体成形术围手术期管理的临床应用. 脊柱外科杂志, 2024, 22(5): 308-312.
12. 刘彩云, 霍晓鹏, 刘晓萱, 等. 基于老年综合评估的预康复在术前衰弱老年肺癌病人中的应用. 实用老年医学, 2024, 38(11): 1153-1157.
13. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J, 1965, 14: 61-65.
14. Balducci L, Stanta G. Cancer in the frail patient. A coming epidemic. Hematol Oncol Clin North Am, 2000, 14(1): 235-250.
15. Chu JJ, Chen XJ, Shen SS, et al. A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension: a cross-sectional study. J Geriatr Cardiol, 2015, 12(2): 113-118.
16. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res, 1982, 17(1): 37-49.
17. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975, 12(3): 189-198.
18. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
19. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
20. Jebb AT, Ng V, Tay L. A review of key likert scale development advances: 1995-2019. Front Psychol, 2021, 12: 637547.
21. 孙立, 陈杰, 申英末. 老年腹股沟疝日间手术注意事项. 中国实用外科杂志, 2018, 38(8): 873-876.
22. 邹妮, 王丹, 傅晟静, 等. 老年患者日间手术全程质量管理模式研究. 中国卫生质量管理, 2022, 29(1): 33-36.
23. 张倩, 张福霞. 我国老年综合评估领域文献的可视化分析. 医学信息, 2024, 37(17): 41-46.
24. Dworsky JQ, Castle SC, Lee CC, et al. Gerofit prehabilitation pilot program: preparing frail older veterans for surgery. J Healthc Qual, 2019, 41(2): 91-98.

West China Medical Journal

Application of comprehensive geriatric assessment in the management of elderly patients undergoing daytime surgery

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