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Preoperative Risk Factors for Discharge to Facility After Surgery in Geriatric Patients
Danielle Abbitt1, Kevin Choy1, Thomas N Robinson1,2
1Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
The American Surgeon
|May 24, 2024
Summary
Preoperative mobility issues and functional dependence in older adults undergoing surgery increase the risk of discharge to a facility. Early intervention by multidisciplinary teams may mitigate this risk.
Area of Science:
- Geriatric surgery
- Perioperative care
- Patient outcomes
Background:
- The Geriatric Surgery Verification Program (GSV) aims to improve surgical outcomes for patients 75 years and older.
- This study evaluates preoperative factors predicting discharge destination in this population.
Purpose of the Study:
- To identify preoperative risk factors for discharge to a facility (e.g., skilled nursing facility, acute rehabilitation) in geriatric surgical patients.
- To inform strategies for improving functional recovery and home return after surgery.
Main Methods:
- Retrospective review of 432 patients aged 75+ undergoing inpatient surgery within the GSV program (2018-2022).
- Preoperative factors assessed: fall history, mobility aid use, housing status, functional status, cognition, and nutrition.
- Outcomes: discharge to home vs. facility.
Main Results:
- 90% of patients were discharged home, while 10% were discharged to a facility.
- Significant predictors for facility discharge included: history of falls (OR 2.95), use of mobility aids (OR 6.0), functional dependence (OR 4.83), and living alone (OR 2.57).
Conclusions:
- Preoperative mobility limitations and functional dependence are key predictors of discharge to a facility in geriatric surgical patients.
- These modifiable factors suggest opportunities for multidisciplinary interventions to reduce facility placement and improve home recovery.
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