English title dissertation Predicting and preventing postoperative decline in older cardiac surgery patients
Name PhD (surname first) Ettema, Roelof
Doctor is (has been) nurse
Date of promotion 13/03/2014
University Utrecht
Promotores Promotoren: Prof. dr. M.J. Schuurmans, Prof. dr. C.J. Kalkman, Prof. dr. K.G.M. Moons, Copromotor: Dr. L.M. Peelen
Linkedin-account linkedin.com
Researchgate-url researchgate.net
Abstract (English)

The proportion of older people in the western population is rapidly growing, and improvements in cardiac surgical techniques and anaesthetic procedures allow surgery even in frail patients. This has the advantage that increasingly older, sicker, and higher-risk patients can undergo cardiac surgery without facing a high mortality risk. However, if these older patients experience postoperative complications, they do not benefit from the surgery. Delirium, depression, pressure ulcers and infections are frequent complications in the postoperative period in older cardiac surgery patients. These complications hamper recovery and are associated with functional and cognitive decline and a decreased quality of life after discharge. Often, this decline has already started before hospital admission. These patients enter the hospital with a below-average health condition, which increases their risk of complications. Therefore, care of older cardiac surgery patients, particularly those who are vulnerable should not be limited to the time spent in the hospital, but the preadmission period should be used to optimize the patient’s condition. This thesis investigates a preparation program, delivered by the nurse, for older patients undergoing cardiac surgery. The first part (chapters one to three) focuses on the selection of older patients at risk of postoperative complications. The second part (chapters four to six) describes the development of a preparation programme for older cardiac surgery patients.

Download dissertation (English) Thesis-final-Ettema-2014.pdf