Elderly people (EP) have increased, as well as life expectancy at birth. In Chile there are more than 2 million 800 thousand EP, which corresponds to 1/6 of the Chilean population. The EP have a higher disease burden and mortality when facing surgery and in the postoperative period. Thus, this population frequently has longer hospital stays due to its degree of fragility, surgical complications or decompensation of its underlying pathologies, directly affecting health care systems. An inadequate preparation of the EP prior to surgery determined that the requirements of in-hospital as well as out-of-hospital care are extended, with the consequent which entails a higher cost in health. Current research underestimates the conditions of frailty and dependence in the EP. In addition, it is not routinely evaluated prior to surgery, as well as nutritional, metabolic, cognitive status and / or delirium screening is performed. There are accelerated recovery programs, which relate their interventions to specific pathologies; however, the age of the person is not taken into account. Surgical pre-habilitation interventions in the EP usually focus their efforts on physical and cardiovascular aspects, not including an integrative pre-surgical evaluation. Based on the foregoing, a prospective, interventional, longitudinal and randomized study has been proposed in a population of the EP who will undergo elective urology and coloproctology surgeries in two university hospitals (private and public). The objective of this study is to evaluate how the implementation of a timely pre-surgical conditioning (APO) protocol for frail elderly people reduces the days of hospital stay. The APO considers the most relevant aspects of physical and cardiovascular pre-habilitation, in addition to contemplating evaluations of frailty, dependence, cognitive status, screening for delirium, nutritional and metabolic.
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Length of hospital stay
Timeframe: Average of 5 to Days of hospital stay until discharge after surgery
Change of the degree of the frailty in the elderly patients during the perioperative process
Timeframe: One month before surgery, the 1 day of the surgery up to 3 months after discharge.
Change of the nutritional and metabolic status in the elderly patients during the perioperative process
Timeframe: One month before surgery, the 1 day of the surgery up to 3 months after discharge.
Assessment functional independence in the elderly patients preoperative and postoperative
Timeframe: One month before surgery, the 1 day of the surgery up to 3 months after discharge.
Change of the cardiorespiratory and muscular system in the elderly patients during the perioperative process
Timeframe: One month before surgery, the 1 day of the after surgery up to 3 days post surgery.