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Table 1 Complete overview of the study period

From: A multicomponent prehabilitation pathway to reduce the incidence of delirium in elderly patients in need of major abdominal surgery: study protocol for a before-and-after study

Time point Study period
Eligibility assessment Trial enrollment 70PLUS outpatient clinic Admission Discharge Discharge + 2 weeks 6-months follow-up 12-months follow-up
Pathology result/ CTA Multidisciplinary meeting T0 – Informed consent obtained T1 T2 T3 T3.5 T4 T5
Assessments
 Laboratory testing   X X X    
 Nurse practitioner or investigator
  Baseline patient characteristics   X      
  Factors of frailty X      
  MMSE X   X   X X
  CCI and ASA X      
  P-POSSUM X      
  ISAR-HP X     X X
  PARKER X     X X
  SNAQ X      
  KATZ-ADL X     X X
  Caregiver burden X    X X X
  CESD-16 X    X X X
  WHOQOL-BREF X    X X X
 Physiotherapist
  10MWT   X      
  TCST X      
  TUG X     X X
  MIP X      
  Handforce X      
 Dietician
  MNA-SF Indications for referral to dietician: Unintentional weight loss Loss of appetite BMI < 22 Undernourishment X      
  BMI X     X X
  SNAQ X      
 Geriatrician
  Comprehensive geriatric assessment Indications for referral to geriatrician: Delirium in history MMSE ≤24 TUG ≥12.6 s Polypharmacy X      
Interventions
 Laboratory testing / Intravenous iron suppletion
  All patients Single dose of 1000 mg Ferric carboxymaltose (Ferinject®) at day care when indicated: Hb level males < 8,1 mmol/L Hb level females < 7,4 mmol/L X      
 Physiotherapist
  All patients 30 min of daily walking or cycling 5 exercises to improve leg muscle strength 2 × 15 minutes respiratory muscle exercise Transfer training when indicated (getting out of bed) X      
 Dietician
  Malnourished patients / MNA-SF < 12 Dietary advice on required protein and calorie intake. Proteins: 1.2 g/kg bodyweight (BMI < 30) Calories: WHO formula for basal need + 30%. Supplements are provided when required protein and calorie intake is not met after dietary advice. X      
 Geriatrician
  Frail patients Non-pharmacological interventions to reduce risk of delirium. Pharmacological interventions (prophylaxis). X      
Time from pathology result to multidisciplinary meeting: < 1 week. Time from multidisciplinary meeting to T0: < 1 week. Time from T0 to T1: < 1 week. Time from T1 to admission: 10 days to 5 weeks
  1. MMSE Mini-Mental State Examination, CCI Charlson Comorbidity Index, ASA American Society of Anaesthesiology, P-POSSUM Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity, ISAR-HP Identification of Seniors At Risk – Hospitalized Patients, CES-D16 Centre for Epidemiological Studies – Depression 16 questions, WHOQOL-BREF World Health Organisation Quality of Life – BREF, 10MWT 10-m Walk Test, TCST Timed Chair Stand Test, TUG Timed-up and Go Test, MIP Maximum Inspiratory Pressure, MNA-SF Mini Nutritional Assessment – Short Form, BMI Body Mass Index, SNAQ Short Nutritional Assessment Questionnaire