Mortality after major surgery is high among older adults who are frail or have probable dementia, a new study has found. The results may aid clinicians in counseling patients and their families about treatment possibilities, the researchers said.

Investigators from the Yale School of Medicine used data from the Centers for Medicare & Medicaid Services to estimate the likelihood of mortality one year after major surgery in community-living US adults. Study participants were fee-for-service Medicare beneficiaries aged 65 or more years. Data on frailty and dementia came from the annual National Health & Aging Trends study.

Among approximately 1,000 major surgery patients overall, 13.4% died in the following year. The rate was even higher in patients who were frail, at 28%, compared with 6% for the nonfrail. Older patients with probable dementia fared worse, with nearly 1 of 3 (33%) dying within the year compared to 12% without probable dementia.

Notably, one-year mortality was threefold higher for nonelective than elective procedures.

Investigators also calculated that post-surgery survival time was reduced by an average of 48.8 days for patients with frailty and 44.9 days for patients with probable dementia.

The results highlight “the potential prognostic value of geriatric conditions,” the authors concluded.

Full findings were published in JAMA Surgery.

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