Impact of a Multidisciplinary Approach in the Perioperative Geriatrics Unit on Functional Status of Patients Aged 70 and Over Operated on for Colorectal Cancer

Centre Hospitalier Universitaire de Nīmes90 enrolled

Overview

Health establishments encourage the development of specific care pathways for the elderly by supporting Geriatric Peri-Operative Units (GPOU). Indeed, this shared care model has shown a clear reduction in mortality and the number of re-hospitalizations in patients 6 months after their care. The multidisciplinary approach of global management of the patient in the perioperative period aims to reduce surgical stress as well as the rapid restoration of previous physical and psychic abilities. Colorectal surgery, the main treatment for stage I to III colon cancer, is a morbid surgery. Despite numerous efficacy data on improved rehabilitation after colorectal surgery, care programs are not specific to the geriatric population and geriatric assessment criteria to describe the functional status of patients are not commonly used. The study investigators wish to evaluate the impact of GPOU treatment following colorectal surgery, on the evolution of several clinical parameters such as: functional status, morbidity mortality, quality of life, and lifestyle. The study investigators hypothesize that management in the GPOU for colorectal cancer surgery in patients aged 70 and over will improve functional status at 3 months, in comparison with traditional management. The proposed intervention should also lead to an improvement in patient satisfaction with care, complications and re-hospitalizations, nutritional status, lifestyle and patient survival.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Colorectal Cancer

Interventions

GPOUOTHER

Intervention upstream of the perioperative management according to the nutritional grade. Grade 4 Nutrition patients will be hospitalized earlier, i.e. 10 to 15 days before surgery for the start of artificial nutrition. A temporary return home can be organized with the supervision of a service provider until a second admission for surgical management. Grade 2 Nutrition patients will be called 24 to 48 hours before the surgical procedure. Anticipation of discharge at admittance Early mobilization Comorbidity management Prevention of iatrogenia Management of geriatric frailties Daily medical and paramedical assessment Detailed discharge report

Eligibility

Sex: ALLMin age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The patient or their representative must have given their free and informed consent and signed the consent form * The patient must be a member or beneficiary of a health insurance plan * Diagnosis of proven colorectal cancer. * Patient to benefit from scheduled colorectal surgery at the University Hospital of Nîmes validated in digestive surgery SPC after oncogeriatric evaluation. * Surgical act: resection with anastomosis in one step. Exclusion Criteria: * Interventional RIPH patient defined as category 1 if there is interference with the primary endpoint * It is impossible to give the subject informed information * The patient is under safeguard of justice or state guardianship

Locations (4)

Coralie LABARIAS

Nîmes, France, France

RECRUITING

Coralie LABARIAS

Nîmes, France, France

RECRUITING

CHU de Nîmes

Nîmes, France

RECRUITING

CHU de Nîmes

Nîmes, France

NOT_YET_RECRUITING

Outcomes

Primary Outcomes

Change in functional status after colorectal cancer surgery between groups

Instrumental Activities of Daily Living (IADL) score (score 0-8)

Time frame: Baseline and Month 3

Secondary Outcomes

Change in functional status between groups

Instrumental Activities of Daily Living (IADL) score (score 0-8)

Time frame: Baseline and Month 6

Change in basic functional status between groups

Katz index of independence in Activities of Daily Living scale (ADL) (score 0-6)

Time frame: Baseline, hospital discharge (an average of 10 days), Month 3, and Month 6

Change in patient motor ability between groups

Time Up and Go test (Score 0-3 for each item, time in seconds)

Time frame: Baseline, Month 3

Patient satisfaction with care between groups

EORTC SATisfaction with IN-PATient cancer care (IN-PATSAT) 32 questionnaire (Score 32-160)