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Older adults with one or more ‘vulnerability factor’ are at increased risk of disability following elective and non-elective surgery, finds a study published in the Journal of the American Geriatrics Society.
The analysis included 247 adults aged 70 years or older who were discharged from the hospital after major surgery between 1997 and 2017.
The burden of disability increased with each additional ‘vulnerability factor’
The researchers identified 10 factors that were associated with greater disability burden. These were: age 85 years or older, female sex, Black race or Hispanic ethnicity, neighbourhood disadvantage, multimorbidity, frailty, one or more disabilities, low functional self-efficacy, smoking, and obesity.
The burden of disability increased with each additional vulnerability factor, with mean values increasing from 1.6 disabilities for 0-1 vulnerability factors, to 6.6 disabilities for 7 or more vulnerability factors.
The corresponding values were 1.2 and 5.9 disabilities for elective surgery and 2.6 and 8.2 disabilities for non-elective surgery.
The study therefore found that patients who had non-elective surgery had more poor functional outcomes over the following six months than those who had elective surgery.
The results can be used to identify older adults who are susceptible to poor functional outcomes after surgery
The authors of the study say the findings can be used to identify older persons who are particularly susceptible to poor functional outcomes after major surgery.
They add that some patients, including those who are frail, have low functional self-efficacy, smoke and are obese, may be amendable to intervention to reduce the risk of disability in the future.
Lead author of the study Thomas M. Gill, MD, of the Yale School of Medicine said the results “can be used by clinicians to identify older adults who are particularly susceptible to poor functional outcomes after major surgery, and a subset of the factors identified could serve as the basis for new interventions to improve functional outcomes in vulnerable older surgical patients.”