MONDAY, March 4, 2024 (HealthDay News) — Major surgery is a dicey proposition for many seniors, with a substantial number landing back in the hospital just weeks or months after their operation, a new study warns.
Nearly one in eight seniors (12%) who undergo surgery are readmitted to the hospital within 30 days of their procedure, researchers report Feb. 28 in the journal JAMA Network Open.
Further, more than a quarter (28%) landed back in the hospital within half a year, results showed.
The risk was even higher for patients who were frail or suffering from dementia.
“These readmission rates are high,” said senior researcher Dr. Robert Becher, an associate professor of surgery at Yale School of Medicine.
These results indicate that surgery can put a senior at higher risk of losing their independence, Becher added. And as the U.S. senior population grows, so will the number of older persons undergoing major surgery.
“From a patient perspective, the most important outcome among older persons with multiple conditions is maintaining independence and function,” Becher said in a Yale news release. “And we know that being readmitted to the hospital after major surgery can negatively impact that independence and function.”
For the study, researchers analyzed hospital readmissions among nearly 1,500 older Americans not living in nursing homes.
The seniors included in the study had at least one major surgery between 2011 and 2018, with nearly 1,800 surgeries in all. The two most common types of surgery were orthopedic and abdominal.
Sepsis, device complications, procedural complications and congestive heart failure were the four most common diagnoses for hospital readmission within both 30 days and six months.
The dangers were even more pronounced for particularly vulnerable older adults: Frail patients and those aged 90 or older were readmitted at a rate of about 37% within six months of surgery, and patients with dementia were readmitted at a rate of 39%.
Overall, patients were more than twice as likely to require readmission within six months if they were frail, and 58% more likely if they had dementia.
The numbers show that it’s important to take into account any frailty or dementia in an older patient before surgery, said senior study author Dr. Thomas Gill, a professor of geriatric medicine at Yale.
The presence of frailty and dementia “may inform patient and family expectations, and surgical decision-making” about what to expect during a senior’s recovery after surgery, Gill said.
Hospital readmissions are more than just a threat to a senior’s independence. They also are a heavy burden on the U.S. health care system, the researchers noted.
Readmission costs totaled more than $50 billion in 2018 alone, driven in part by nearly 3.8 million hospital readmissions that occurred within 30 days of release, researchers said. The vast majority of those patients were Medicare beneficiaries aged 65 and older.
The researchers next plan to study why vulnerable older Americans have such high readmission rates, and figure out ways to reduce the risk of readmission.
More information
Johns Hopkins Medicine has more on hospital readmissions.
SOURCE: Yale University, news release, Feb. 28, 2024
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