Publication:
Effects of a Modified Hospital Elder Life Program on Frailty in Individuals Undergoing Major Elective Abdominal Surgery

Thumbnail Image

Date

2014

Published Version

Journal Title

Journal ISSN

Volume Title

Publisher

Wiley-Blackwell
The Harvard community has made this article openly available. Please share how this access benefits you.

Research Projects

Organizational Units

Journal Issue

Citation

Chen, Cheryl Chia-Hui, Chiung-Nien Chen, I-Rue Lai, Guan-Hua Huang, Jane S. Saczynski, and Sharon K. Inouye. 2014. “Effects of a Modified Hospital Elder Life Program on Frailty in Individuals Undergoing Major Elective Abdominal Surgery.” J Am Geriatr Soc 62 (2) (January 17): 261–268. doi:10.1111/jgs.12651.

Research Data

Abstract

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 years and older ((N = 189) undergoing elective, major 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: non-frail (0 or 1 criteria present), pre-frail (2 or 3 criteria present), and frail (4 or 5 criteria present). Results Among matched pairs, participants who received the mHELP interventions were significantly less likely to be frail at discharge (19.2% vs. 65.4% for controls; adjusted OR = .10, 95% CI = .02 to .39) than their matched controls. Transitions to states of greater frailty during hospitalization were more common for participants in the control group. At 3 months post-discharge, participants who received the mHELP intervention during hospitalization were less likely to be frail than the matched controls (17.3% versus 23.1%; adjusted OR = .73; 95% CI = .21 to 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 post-discharge. Thus, the mHELP provides a useful approach to manage in-hospital frailty for older patients undergoing major abdominal surgery.

Description

Keywords

frailty, aged, intervention studies, surgery, geriatric syndromes

Terms of Use

This article is made available under the terms and conditions applicable to Other Posted Material (LAA), as set forth at Terms of Service

Endorsement

Review

Supplemented By

Referenced By

Related Stories