Aims:
The aging global population is a successful outcome of public health. Resulting in an increasing number of patients undergoing surgery at older ages, with increasing frailty and numbers of co-morbidities (1). This study aimed to evaluate the impact of geriatrician-led pre-operative assessment on surgical outcomes in older adults undergoing elective general surgery by comparing patients who attended the geriatric pre-operative clinic with those who received standard pre-operative care. Outcomes were assessed using post-operative indicators including length of hospital Stay (LoS), hospital-acquired complications, readmissions, and mortality. The project also aimed to assess whether incorporating Comprehensive Geriatric Assessment into pre-operative pathways improves perioperative outcomes in a frail and comorbid surgical population.
Methods:
A retrospective review was undertaken of 100 patients aged ≥65 years (≥60 for Aboriginal and Torres Strait Islander patients) who underwent elective general surgery between January 2024 and August 2025. Fifty patients attended the GPS and received CGA, while fifty underwent standard pre-operative care. Inclusion criteria of a Clinical Frailty Scale greater than or equals to 2, or co-morbidity number of two or greater. Outcomes included LoS, hospital-acquired complications (HACs),, readmission rate, and mortality.
Results:
Patients that attended GPS had significantly shorter LoS (6.5 vs 10.4days;p=0.0055).Patients seen in the GPS had approximately 22% lower odds of a HACs, fewer readmissions and no deaths. However, these differences were not statistically significant.
Conclusion:
Despite greater frailty and increased number of comorbidities in the GPS cohort, a reduction in LoS was appreciated. These findings support the integration of geriatric assessment into preoperative care pathways.