Older adults who have a major surgery have a higher risk for being readmitted to the hospital within 180 of a procedure. The risk is even more so if the person is frail or has dementia, according to a study published Wednesday in JAMA Network Open.
The same team found that major surgery is common in older adults in the United States, and it comes with a higher risk for dying within a year of surgery for people ages 65 and older. In the study, researchers looked at the short-term risk for death within 30 days of an operation as well as within the 180-day span.
The scientists evaluated 1,477 older adults who didn’t live in nursing homes and had at least one major surgery between 2011 and 2018. Of them, 1 in 4 were readmitted to the hospital within 180 days and 1 in 8 had to go back within 30 days. For those with frailty or dementia, the risks were higher. Of frail patients, 36.9% were readmitted within 180 days, and of those thought to have dementia, 39% were admitted within the same time frame. Nearly 37% of participants who were over the age of 90 were readmitted in the 180-day period.
“Prior to now, data on longer-term readmissions after major surgery in older persons have been lacking. This is problematic, as older persons undergoing major surgery represent a large and growing population,” Robert D. Becher, MD, associate professor of surgery at Yale School of Medicine and co-senior author of the study, said in Medical Xpress. “These readmission rates are high. And this study adds to our understanding of what it means to recover from major surgery as an older person.”
“These findings reinforce the importance of enhanced preoperative recognition of frailty and dementia in older persons and may inform patient and family expectations — and surgical decision making — about postoperative trajectories in the setting of these geriatric conditions,” Thomas M. Gill, MD, the Humana Foundation Professor of Geriatric Medicine at Yale and co-senior author of the study, also said.
The team still wants to study why vulnerable older people have high readmission rates. The researchers also want to come up with ways to lower their risk for readmission, the authors said.
