New research published by the American College of Surgeons suggests that being able to remain independent after surgery plays a big role in having better outcomes after surgery.
It may sounds obvious, and maintaining independence and mobility is a huge part of an occupational therapist or physical therapist’s job, but it’s easier said than done. Nearly 60 percent of patients over the age of 65 who undergo surgery lose at least some of their independence after surgery, said lead author Dr. Julia Berian.
“Because physicians rarely evaluate measures such as function, mobility and discharge destination, such outcomes are not usually discussed,” Berian told Reuters Health. “It is something that should be tracked post-operatively, and perhaps should be discussed pre-operatively before the decision to operate is made.”
Surgical Outcome Study
For their study, researchers analyzed data on more than 5,000 patients over the age of 65 years old, including assessments on function, mobility and living situation both before and after surgery. No specific operations were tracked, and oftentimes patients simply needed general surgery, although the most common procedures performed were gynecological and vascular operations.
After looking at the data, researchers uncovered that losing function, mobility or needing more care after surgery was linked to a higher risk of being readmitted to the hospital or dying. Here are some other findings from the study:
- Being less independent after discharge was more common for older adults, affecting more than 4 out of 5 patients over the age of 85.
- More than 3,000 of the 5,000-plus patients lost some independence after surgery.
- About 10 percent of patients were readmitted to the hospital within 30 days of initial discharge.
- Factors that increased a person’s likelihood of readmission include having a complication after surgery, being less fit, and experiencing loss of independence.
- 69 patients died within a month of discharge.
- Those who experienced a loss of independence were more than six times as likely to die as those who did not lose independence.
“We are not very good at anticipating the support that will be needed for older adults to continue their postoperative recovery at home,” said Dr. Emily Finlayson of the University of California, San Francisco, who co-authored an editorial alongside the results. “Even when we do, family and community resources are too often not available to provide what is needed to help older adults transition back to independence after surgery.”
When adults can’t remain independent after surgery, they can miss meals, forget to take medication, become dehydrated or suffer a fall, which can all lead to hospital readmission. Authors said patients could help remain independent by taking some steps before their operation, like improving their diet, getting regular exercise, preparing meals, arraigning for a friend or family member to stay with them for a few days and by purchasing assist devices like grip bars and walkers.