ObjectiveTo determine the feasibility of preoperative comprehensive geriatric assessment (CGA) and multidisciplinary team (MDT) input for older people undergoing elective orthopaedic surgery in a tertiary New Zealand setting.MethodsThis single‐centre retrospective study included elective orthopaedic patients older than 65 years (and Māori/Pasifika aged greater than 55 years) with hyperpolypharmacy, frailty, neurocognitive disorders and poor functional status. Patients attended a preoperative clinic where they had a geriatrician‐led CGA along with MDT input. The feasibility of this preoperative model was assessed using outcomes of acceptability, accessibility and adherence. A qualitative description of patient demographics along with clinic assessment and interventions further describes this pilot experience.ResultsSixty patients met inclusion criteria. This group were vulnerable older people (median age 77 years), with a high incidence of hyperpolypharmacy (85%), frailty (80%) and neurocognitive disorders (30%). Acceptability was high (97%), along with CGA accessibility (100%); however, MDT accessibility varied (53–90%). Adherence to MDT intervention was low; with only 26% of patients completing physiotherapy sessions and only 29% adhering to dietary advice. Accurate recall was a significant factor contributing to poor adherence. Comprehensive geriatric assessment was demonstrated to be a broad and flexible intervention.ConclusionsCGA with MDT input is an acceptable and accessible intervention to be utilised as part of improved preoperative care for the older person undergoing elective orthopaedic surgery. Further consideration around methods to increase adherence in this patient group should be explored. Future research should focus on refining the intervention, and quantifying impact on patient outcomes.

中文翻译：

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接受择期骨科手术的老年人的术前综合老年评估和多学科团队的投入：可行性试验

目的 确定对在新西兰三级机构接受择期骨科手术的老年人进行术前综合老年评估 (CGA) 和多学科团队 (MDT) 的可行性。方法这项单中心回顾性研究包括 65 岁以上的择期骨科患者（以及毛利人）。 /年龄超过 55 岁的太平洋岛民）患有过度用药、虚弱、神经认知障碍和功能状态不佳。患者在术前诊所接受了老年科医生主导的 CGA 以及 MDT 的输入。使用可接受性、可及性和依从性的结果来评估该术前模型的可行性。对患者人口统计数据的定性描述以及临床评估和干预措施进一步描述了这一试点经验。结果 60 名患者符合纳入标准。该群体是易受伤害的老年人（中位年龄 77 岁），过度用药（85%）、虚弱（80%）和神经认知障碍（30%）的发生率很高。可接受性很高（97%），CGA 的可及性也很高（100%）；然而，MDT 的可及性各不相同 (53-90%)。 MDT 干预的依从性较低；只有 26% 的患者完成物理治疗，只有 29% 的患者遵守饮食建议。准确回忆是导致依从性差的一个重要因素。综合老年评估被证明是一种广泛而灵活的干预措施。结论结合 MDT 输入的 CGA 是一种可接受且易于使用的干预措施，可作为改善接受择期骨科手术的老年人术前护理的一部分。应进一步考虑提高该患者群体依从性的方法。未来的研究应侧重于完善干预措施并量化对患者结果的影响。