随着中国人口寿命的延长以及手术和麻醉技术的改进，接受手术的老年患者人数逐年增加。然而,安全,有效性,老年手术患者的生活质量面临重大挑战。为了规范围手术期的评估和程序,我们开发了一种围手术期评估和辅助决策系统，名为“老年患者围手术期纵向评估-多学科试验(APPLE-MDT)”。
我们将进行围手术期风险评估和针对性干预，术后1、3和6个月的随访。该研究的主要目的是评估“老年患者围手术期纵向评估-多学科试验路径”（以下简称APPLE-MDT路径）在手术室非局部麻醉下进行择期手术的老年患者（≥75岁）的手术决策中的有效性。本研究的次要目标是评估APPLE-MDT路径应用于非局部麻醉下择期手术的老年患者（≥75岁）的手术决策的术后结局和健康经济学，并优化干预策略。老年患者接受手术，以减少术后并发症的发生，提高术后生活质量。
有必要制定一个可靠的，有效,和简洁的评估工具，能有效预测老年患者围手术期并发症和死亡率,支持有针对性的干预策略，并允许更全面的风险和收益分析，从而形成有效的老年围手术期手术管理路径。预计该方案的实施可以减少术后并发症的发生，提高术后生活质量，缩短住院时间,减少住院费用，减轻社会负担,让老年人术后有良好的生活质量。
ChiCTR,ChiCTR1800020363,2018年12月15日注册
With the extended life expectancy of the Chinese population and improvements in surgery and anesthesia techniques, the number of aged patients undergoing surgery has been increasing annually. However, safety, effectiveness, and quality of life of aged patients undergoing surgery are facing major challenges. In order to standardize the perioperative assessment and procedures, we have developed a perioperative evaluation and auxiliary decision-making system named \"Aged Patient Perioperative Longitudinal Evaluation-Multidisciplinary Trial (APPLE-MDT)\".
We will conduct a perioperative risk evaluation and targeted intervention, with follow-ups at 1, 3, and 6 months after surgery. The primary objective of the study is to evaluate the effectiveness of the \"Aged Patient Perioperative Longitudinal Evaluation-Multiple Disciplinary Trial Path\" (hereinafter referred to as the APPLE-MDT path) in surgical decision-making for aged patients (≥75 years) undergoing elective surgery under non-local anesthesia in the operating room. The secondary objectives of the study are to evaluate the postoperative outcome and health economics of the APPLE-MDT path applied to the surgical decision-making of aged patients (≥75 years) undergoing elective surgery under non-local anesthesia and to optimize intervention strategies for aged patients undergoing surgery to reduce the occurrence of postoperative complications and improve the quality of life after surgery.
It is necessary to formulate a reliable, effective, and concise evaluation tool, which can effectively predict the perioperative complications and mortality of aged patients, support targeted intervention strategies, and allow for a more comprehensive risk and benefit analysis, thereby forming an effective senile perioperative surgery management path. It is expected that the implementation of this protocol can reduce the occurrence of postoperative complications, improve the postoperative quality of life, shorten hospital stay, reduce hospitalization expenses, reduce social burden, and allow the elderly to have a good quality of life after surgery.
ChiCTR, ChiCTR1800020363 , Registered 15 December 2018.
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