{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:08:48Z","timestamp":1785528528808,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is increasing evidence to support collaborative care and proactive comprehensive geriatric assessment and management in a number of surgical specialties. Data are lacking in older people under the care of plastic surgeons. This before\/after study evaluates the impact of the introduction of a shared care model between geriatric medicine and plastic surgery in an Australian metropolitan teaching hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A shared care model was implemented for all patients aged 75\u2009years and older admitted electively and emergently under the plastic surgery team with patients admitted jointly under a plastic surgeon and geriatrician. Comprehensive geriatric assessment and management was undertaken on admission with tailored intervention along with regular inpatient review. The primary outcome of interest was rate of in\u2010hospital complications. Secondary outcome measures included individual complications, length of stay, readmission, and discharge disposition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 123 consecutive patients were eligible for inclusion (63 pre\u2010intervention, 60 intervention). The rate of complications was significantly lower in the intervention group (47.6% vs. 28.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.03). There was a non\u2010significant reduction in rate of delirium and new discharge to residential aged care facility. Subgroup analysis of frailer patients (Clinical Frailty Scale \u22654) demonstrated a significant reduction in rates of delirium (44.4% vs. 15.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.02) and new institutionalization (18.5% vs. 0.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A shared care model between geriatricians and plastic surgeons has the potential to improve patient outcomes with the greatest benefit likely to be seen in older patients with frailty.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.19340","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T07:35:09Z","timestamp":1733988909000},"page":"517-522","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reducing in\u2010hospital complications in older patients undergoing plastic surgery through a collaborative model of care"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3182-8328","authenticated-orcid":false,"given":"Sonya","family":"Jung","sequence":"first","affiliation":[{"name":"School of Clinical Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Falls, Balance and Injury Research Centre (FBIRC) Neuroscience Research Australia  Sydney New South Wales Australia"},{"name":"Department of Geriatric Medicine The Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine The Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Norris","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Falls, Balance and Injury Research Centre (FBIRC) Neuroscience Research Australia  Sydney New South Wales Australia"},{"name":"Department of Geriatric Medicine The Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqui","family":"Close","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Falls, Balance and Injury Research Centre (FBIRC) Neuroscience Research Australia  Sydney New South Wales Australia"},{"name":"Department of Geriatric Medicine The Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac194"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr182"},{"key":"e_1_2_8_4_1","article-title":"Comprehensive geriatric assessment for older adults admitted to hospital","volume":"2017","author":"Ellis G","year":"2017","journal-title":"Cochrane Database Syst. 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