Research Abstract: Free Paper - Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Development of a minimum clinical dataset for preoperative comprehensive geriatric assessment and optimisation using a modified Delphi technique (#68)

Margot Lodge 1 2 3 , Yih Harng Chong 4 5 , Rachel Aitken 6 , Janani Thillainadesan 7 8 9
  1. National Centre for Healthy Ageing, Melbourne, Victoria, Australia
  2. Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
  3. Health of Older People, Alfred Health, Melbourne, Victoria, Australia
  4. School of Medicine, University of Auckland, Auckland, New Zealand
  5. Orthopaedic Department, North Shore Hospital, Waitemata DHB , Auckland, New Zealand
  6. Department of Aged Care, Royal Melbourne Hospital, Parkville, Victoria, Australia
  7. Department of Geriatric Medicine, Concord Hospital, Concord, Sydney, Australia
  8. Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
  9. Centre for Education and Research on Ageing, Concord Hospital, Sydney, New South Wales, Australia

Aims: To construct a standardised, evidence-based and consensus-guided minimum clinical dataset (MCDS) for preoperative comprehensive geriatric assessment and optimisation (CGA) in Australia and Aotearoa New Zealand.

Methods: Our expert working group conducted a comprehensive literature review to identify CGA domains for inclusion in the MCDS and establish which domain-specific tools were reported in the perioperative literature. We then invited members of the Australian and New Zealand Society for Geriatric Medicine to participate in a Delphi study to obtain consensus on MCDS tools. The Delphi study was constructed to achieve consensus on a single preferred tool for each domain except cognition for which we aimed to achieve consensus on the top three preferred tools. Participants were asked to rate proposed tools using Likert scales (when >2 tools) or make a binary choice between two proposed tools. Consensus was established using descriptive statistics (modes and proportions). Domains that did not achieve consensus in round 1 were carried over to round 2.

Results: Seven CGA domains were recognised in the literature review. Multiple assessment tools for each domain were identified. 73 people participated in round 1 of the Delphi study and 47 people in round 2. Consensus was achieved on tool/s recommended for every MCDS domain: Rockwood Clinical Frailty Scale (frailty); sMMSE, RUDAS, MoCA (cognition); 4AT (delirium); timed-up-and-go (physical function); GDS-15 (mood); Barthel Index (functional status); MUST (malnutrition).

Conclusion: We recommend that geriatricians delivering preoperative CGA consider the use of the MCDS we have constructed when assessing older people contemplating or undergoing surgery.