Octogenarians unable to return home by postoperative-day 30

Area of Science:

• Geriatric Surgery
• Surgical Outcomes
• Patient Recovery

Background:

• Returning home is crucial for functional independence in older adults post-surgery.
• Quantifying octogenarians not returning home by post-operative day 30 (POD-30) is essential.
• Identifying geriatric risk factors can improve decision-making and quality of care.

Purpose of the Study:

• To quantify the rate of non-home living at POD-30 in octogenarians.
• To assess geriatric factors within a predictive model for non-home discharge.
• To identify specific risk factors for non-home discharge.

Main Methods:

• Retrospective cohort study of patients aged 80 years and older.
• Utilized data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot.
• Employed sequential logistic regression modeling to determine the primary outcome of non-home living location at POD-30.

Main Results:

• 19.8% of 4946 patients lived in non-home facilities at POD-30.
• Preoperative fall history (OR 2.92) and new postoperative pressure ulcers (OR 2.66) significantly increased odds of non-home living.
• Other key risk factors included mobility aid use, surrogate-signed consent, and postoperative delirium.

Conclusions:

• Geriatric-specific risk factors are critical indicators for post-discharge outcomes.
• Preoperative vulnerability screening and targeted interventions are vital for surgical decision-making.
• Proactive management of identified risk factors can enhance functional independence and home recovery for older surgical patients.