Predictors against discharge to home in geriatric emergency general surgery patients

This study aims to identify predictors of discharge to post-acute care in geriatric emergency general surgery (EGS) patients.

This is a retrospective study of geriatric emergency general surgery (EGS) patients at a tertiary care facility between 2017 and 2018. Inclusion criteria were ≥ 65 years old and presented directly from home. Non-survivors or those admitted from a healthcare facility were excluded. The primary outcome was discharge to home versus post-acute care.

Out of 577 patients, the median age was 74, and 36.9% were discharged to a post-acute care facility. Factors predicting discharge to post-acute care were: mobility aid use (1.92, [1.19-3.11], p = 0.008), cerebrovascular accident (4.67, [1.99-10.94], p < 0.001), delirium (11.06, [2.29-53.43], p = 0.003), pre-operative transfusion (2.39, [1.13-5.08], p = 0.023), fall history (3.74, [1.90-7.36], p < 0.001), AKI (5.42, [2.61-11.25], p < 0.001), and lack of capacity to consent (4.11, [2.10-8.02], p < 0.001). Non-operative management was protective against discharge to post-acute care (0.38, [0.24-0.60], p < 0.001).

Early recognition of the role of these factors in influencing discharge disposition may help with clinical decision-making and discharge planning.