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Comparative outcomes for older adults undergoing surgery for bladder and bowel dysfunction.

Anne M Suskind1, Shoujun Zhao1, Farnoosh Nik-Ahd1

  • 1Department of Urology, University of California, San Francisco, San Francisco, California, USA.

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Summary

Nursing home residents had higher surgical complication and mortality risks for bladder and bowel dysfunction compared to community-dwelling adults. However, they utilized fewer healthcare resources post-surgery.

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Area of Science:

  • Geriatric Surgery
  • Health Services Research
  • Urology

Background:

  • Vulnerable nursing home residents often have different health profiles than community-dwelling older adults.
  • Surgical outcomes for common procedures like bladder and bowel dysfunction surgeries are critical for this population.

Purpose of the Study:

  • To compare surgical outcomes between nursing home residents and matched community-dwelling older adults undergoing surgery for bladder and bowel dysfunction.
  • To analyze differences in complications, mortality, and healthcare resource utilization.

Main Methods:

  • Retrospective cohort study of 55,389 nursing home residents and matched community-dwelling older adults.
  • Data sourced from Medicare claims and Minimum Data Set (MDS) between 2014-2016.
  • Propensity matching based on procedure, age, sex, race, comorbidity, and year.

Main Results:

  • Nursing home residents had significantly higher 30-day complication rates (60.1% vs. 47.2%) and 1-year mortality (28.9% vs. 21.3%).
  • Nursing home residents showed decreased healthcare resource utilization post-surgery compared to community-dwelling peers.
  • Specific procedures included female pelvic surgery, prostate surgery, suprapubic tube placement, and hemorrhoid/rectal prolapse surgery.

Conclusions:

  • Nursing home residents face increased surgical risks for bladder and bowel dysfunction despite matching on key characteristics.
  • Findings suggest varied outcomes in vulnerable older adults, necessitating further investigation.
  • Reduced healthcare resource utilization in nursing home residents warrants further exploration of care patterns.