Despite an aging population and safer surgical procedures, the frequency of abdominal surgery is decreasing among older adults — particularly in those aged 85 or more years, according to researchers from the University of Chicago Medicine.

Investigators analyzed data from 2002 to 2014 and found a “stark” decrease in the number of these surgeries overall, which they attributed to improvements in medical treatments and cancer screening for older adults. What’s more, the study found that more than half of adults over age 85 will require some post-acute care after a surgical procedure.

“This suggests we’re getting better at determining who would benefit most from a surgery, and also possibly that we’ve developed better and less invasive alternative treatments,” said first author Daniel Rubin, M.D., associate professor of anesthesia and critical care. 

He and his colleagues were surprised to find certain exceptions. Those appeared to be driven by a large shift away from abdominal surgeries in rural and non-teaching urban hospitals. Instead, the frequency of these procedures performed on older adults increased in urban medical centers and teaching hospitals. This finding may be due to consolidated, increased specialization in those institutions, the authors wrote.

The findings may help older adults and their caregivers make decisions about whether to undergo surgery, Rubin said.

“It’s important for patients and their families to understand that these surgeries can lead to a challenging recovery trajectory for older adults, even if the surgery goes well,” he said.

“Older adults really want to get back to their normal life after an operation, but recovery can be difficult, and the rates at which older adults require post-acute care — such as time in a rehabilitation facility or long-term care — is high,” Rubin concluded. “These results can help inform the decisions made by patients and providers on whether or not a surgery is the right choice for them.”

Full findings were published Mon., May 10 in the Journal of the American Geriatric Society.