248 BENEFITS OF POST-OPERATIVE SPECIALIST GERIATRIC CARE FOR OLDER PATIENTS UNDERGOING ELECTIVE ORTHOPAEDIC SURGERY. (25th October 2022) - McGarvey, C
Abstract: Background: The Covid-19 pandemic changed work practices across many different healthcare institutions. The difficulties with cross-site transfers created an opportunity in our institution to provide on-site post-operative rehabilitation for older patients undergoing elective orthopaedic surgery. The aim of this study is to assess the impact of post-operative specialist geriatric care on older patients. Methods: This is a single-centre, retrospective study that received approval from the local hospital ethics committee. Data were collected on all patients admitted to the on-site specialist rehabilitation unit post-elective orthopaedic surgery between 1st May 2020 and 31st December 2021. Two patients in this group were excluded as they had not attended a pre-operative assessment clinic. Data were collected from hospital Information Technology platform, Bluespiers. Results: 76 patients, 18 males and 58 females, were included in this study. The median age was 80 years. In the specialist rehabilitation unit, evidence of cognitive impairment was established in 40.79% of cases, there were 3 cases of newly diagnosed dementia, a history of falls was identified in 32.89% of patients and 13.16% of patients were found to have sarcopaenia. The median length of stay in the rehabilitation unit was 25 days. 51.32% of patients were discharged home independently, 23.68% of patients went home with a new Home-Care Package (HCP), 15.79% of patients were discharged home with an existing HCP, 6.58% of patients were transferred for further treatment and 2.63% patients were discharged to residential care units. Conclusion: This data demonstrates a clear role for specialist geriatric care in elective rehabilitation, with a significant proportion of patients being discharged home independently. The benefits of a comprehensive geriatric assessment in the peri-operative setting include increased identification of cognitive impairment allowing appropriate implementation of brain health as well as identification of a history of falls, enabling falls risk assessment and management including bone health assessment.