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Octogenarians unable to return home by postoperative-day 30.

Peters XD, Zhang LM, Liu Y, Cohen ME, Rosenthal RA, Ko CY, Russell MM. Octogenarians unable to return home by postoperative-day 30. American journal of surgery. 2024 Aug 23; 238:115926.

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Abstract:

BACKGROUND: For older adults undergoing surgery, returning home is instrumental for functional independence. We quantified octogenarians unable to return home by POD-30, assessed geriatric factors in a predictive model, and identified risk factors to inform decision-making and quality improvement. METHODS: This retrospective cohort study examined patients 80 years old from the ACS NSQIP Geriatric Surgery Pilot, using sequential logistic regression modelling. The primary outcome was non-home living location at POD-30. RESULTS: Of 4946 patients, 19.8  % lived in non-home facilities at POD-30. Increased odds of non-home living location were seen in patients with preoperative fall history (OR 2.92, 95%CI 2.06-4.14) and new postoperative pressure ulcer (OR 2.66, 95%CI 1.50-4.71) Other significant geriatric-specific risk factors included mobility aid use, surrogate-signed consent, and postoperative delirium, with odds ratios ranging from 1.42 (1.19-1.68) to 1.97 (1.53-2.53). CONCLUSIONS: These geriatric-specific risk factors highlight the importance of preoperative vulnerability screening and intervention to inform surgical decision-making.




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