Geriatric Vulnerability Ups Risk for Disability After Major Surgery

MONDAY, March 7, 2022 (HealthDay News) — The burden of disability after hospital discharge for major surgery increases progressively with an increasing number of geriatric vulnerability factors, according to a study published online Feb. 24 in the Journal of the American Geriatrics Society.

Thomas M. Gill, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues evaluated the association between geriatric vulnerability and the burden of disability after hospital discharge for major surgery. The analysis included 327 admissions for major surgery among 247 nondisabled community-living older adults (aged 70 years or older) discharged from the hospital (March 1997 to December 2017). Disability was assessed monthly through 13 essential, instrumental, and mobility activities.

The researchers found that the burden of disability during the six months after major surgery was considerably greater for nonelective than elective surgery. Ten factors were independently associated with disability burden, including age 85 years or older, female sex, Black race or Hispanic ethnicity, neighborhood disadvantage, multimorbidity, frailty, one or more disabilities, low functional self-efficacy, smoking, and obesity. With each additional vulnerability factor, the burden of disability increased with mean values (increasing from 1.6 disabilities for one or fewer vulnerability factors to 6.6 disabilities for seven or more vulnerability factors). For elective surgery, the corresponding values were 1.2 and 5.9 disabilities, and for nonelective surgery, the corresponding values were 2.6 and 8.2 disabilities.

“These factors can be used to identify older persons who are particularly susceptible to poor functional outcomes after major surgery, and a subset may be amenable to intervention, including frailty, low functional self-efficacy, smoking, and obesity,” the authors write.

Abstract/Full Text