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Elderly long-stay surgical patients.

K Rockwood1, P Rockwood, W H Eaton

  • 1Faculty of Medicine, Memorial University of Newfoundland, St. John's.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|January 1, 1988
PubMed
Summary

Older surgical patients with cognitive impairment and pre-admission dependence experienced longer hospital stays. Many were suitable for discharge if community accommodation was available, highlighting a gap in post-hospital care for elderly surgical patients.

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Area of Science:

  • Geriatric Medicine
  • Surgical Patient Care
  • Healthcare Management

Background:

  • Long hospital stays (exceeding 30 days) are a concern in acute-care settings.
  • Identifying factors contributing to prolonged stays in elderly surgical patients is crucial for resource optimization.

Purpose of the Study:

  • To investigate the characteristics and predictors of long hospital stays among surgical patients aged 65 and older.
  • To determine if specific patient factors are associated with prolonged hospitalization in this demographic.

Main Methods:

  • Retrospective analysis of 196 surgical patients over 65 years old admitted to two acute-care hospitals.
  • Comparison of demographic, clinical, and admission characteristics between long-stay (≥30 days) and short-stay patient groups.

Main Results:

  • 54 patients (28%) experienced long hospital stays.
  • Long-stay patients demonstrated significantly higher rates of cognitive impairment, pre-admission dependence, and emergency department admissions (p < 0.05).
  • These patients more frequently required catheterization and prolonged bed rest or "gerichair" use.

Conclusions:

  • Cognitive impairment and pre-admission functional dependence are key predictors of extended hospital stays in older surgical patients.
  • Despite complex care needs, a substantial proportion of long-stay patients could be discharged to the community with adequate support and accommodation.
  • Addressing accommodation barriers is essential for improving discharge planning and reducing prolonged hospitalizations in the elderly surgical population.

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