4 indicators that older patients aren’t ready to go home after surgery

A history of falls and postoperative delirium are among four key factors that can help clinicians predict whether an older patient is able to return home, new research shows.

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The research was presented at the ACS Quality and Safety Conference, which ended July 22 in Washington, D.C.

Researchers used data from the American College of Surgeons National Surgical Quality Improvement Program Geriatric Surgery Pilot Project. The project was established in 2014 to measure the quality of surgical care for older adults in the U.S.

They examined data for 3,696 patients in the geriatric surgery pilot registry who underwent procedures between 2015 and 2017. Eighteen percent of the patients were still living in a care facility 30 days after surgery.

The study shows that the four characteristics common among these older patients were:

• A history of a fall within the last year
• Preoperative malnutrition
• Postoperative delirium
• A new or worsening pressure ulcer after surgery

“This information should help us make better preoperative decisions with our patients by allowing us to tell them about the impact a surgical procedure will have on their way of life,” said Ronnie Rosenthal, MD, the study’s co-author and a professor of surgery and geriatrics at Yale University School of Medicine.

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