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Disparities in Surgical Oncologic Care

E122: The Impact of American College of Surgeons’ Geriatric Surgery Verification Program in Patients Aged 65 and above Undergoing Major Abdominal Oncologic Operations at a Community Hospital

ePoster Abstract Author(s)

Mercy N. Jimenez, MD

Complex General Surgical Oncology Fellow
Roger Williams Medical Center/Boston University
Providence, Rhode Island, United States

Submitter(s)

Mercy N. Jimenez, MD

Complex General Surgical Oncology Fellow
Roger Williams Medical Center/Boston University
Providence, Rhode Island, United States

Author(s)

Mercy N. Jimenez, MD

Complex General Surgical Oncology Fellow
Roger Williams Medical Center/Boston University
Providence, Rhode Island, United States
PS

Ponnandai Somasundar, MD,FACS,

Chief of Surgical Oncology Division
Boston University, United States
JD

Jayme Dandeneau, RN, BSN, OCN

Surgical Oncology Nurse Navigator
Roger Williams Medical Center, United States
AD

Amanda DiMeo, MPH

PA student
Boston University, United States
JF

Jose Fernandez, MD

Surgical Resident
Flushing Hospital Medical Center, United States
LV

Lidia Vognar, MD

Geriatrician, Assistant Professor of Medicine
Brown University, United States
JA

Joanna Abi Chebl, MD

Geriatrics Fellow
Roger Williams Medical Center, United States
SK

Steve Kwon, MD, MPH, FACS

Associate Surgical Oncology Attending
Boston University, United States

Introduction: The United States population is living longer and the frequency of surgical operations performed for cancer in older adults is increasing. Older adults are at higher risk for surgery and are less likely to be discharged to home from the hospital than their younger cohorts. The objective of the study was to evaluate the impact of the American College of Surgeons (ACS) Geriatric Surgery Verification (GSV) Program on clinical outcomes in patients aged 65 or more undergoing major abdominal oncologic surgery.

Methods: A retrospective study of patients aged 65 years or more undergoing major oncologic abdominal surgery with an inpatient stay for at least two days was performed from 2021-2022. The intervention was defined as the initiation of participation in the ACS GSV Program (and adherence to the program’s standards) at the start of 2022 and these patients were followed prospectively by our surgical oncology nurse navigator. Patients meeting inclusion criteria the year prior were used as the control group. The main outcome measures included length of stay, emergency department visits within 30 days, and the change in patients' primary residence after surgery.

Results: There were a total of 45 patients in the intervention group and 57 patients in the control group. The average age of patients was 75.1 years (± 6.31 SD) in the control group and 76.5 years (± 7.42 SD) in the intervention group. Differences in mean patient age, Charlson comorbidity score, and types of procedures were not statistically significant between groups. The intervention group had a shorter mean length of stay (6.47 ± 3.57 days) vs (4.44 ± 2.54 days) (p-value< 0.01) and decreased 30-day emergency department visits (26.32% vs. 16.28%, p-value=0.03). Patients in the intervention group were more likely to be discharged to their preoperative place of residence compared to the control group (55.56% control vs. 36.59% intervention, p-value=0.03).

Conclusions:
Implementation of the ACS GSV program in patients aged 65 plus undergoing major oncologic abdominal surgery was associated with shorter length of stay, fewer 30-day emergency department visits, and patients being more likely to return to their primary place of residence.

Learning Objectives:
Upon completion, participants will be aware of the American College Surgeons Geriatric Surgery Verification program and its applicability to a broader range of patients aged 65 or older.
Upon completion, participants will appreciate how geriatric patients' living situation changes after surgery and how initiatives to help them return to their primary place of residence are necessary.
Upon completion, participants will understand that implementing the ACS GSV program may decrease the length of stay and emergency room visits in patients aged 65 plus undergoing major surgery.