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- Title
Mortality and Functional Outcomes After Minor Urological Surgery in Nursing Home Residents: A National Study.
- Authors
Suskind, Anne M.; Zhao, Shoujun; Walter, Louise C.; Boscardin, W. John; Finlayson, Emily
- Abstract
Objectives: To determine outcomes of minor urological surgery in frail older adults. Design: Retrospective cohort study. Setting: U.S. nursing homes (NHs). Participants: NH residents aged 65 and older undergoing minor inpatient urological surgery (cystoscopy, bladder biopsy, transurethral resection of bladder tumor, prostate biopsy, transurethral resection of prostate, removal of ureteral obstruction, suprapubic tube placement) in the United States between 2004 and 2012 (N=34,605). Measurements: One‐year mortality and changes in functional status before and after surgery using the Minimum Data Set Activity of Daily Living (MDS‐ADL) summary scale. Results: Overall 1‐year mortality was 50%, and on average, residents had a 1.9‐point worsening in their MDS‐ADL score at 1 year, whereas the most highly functional residents (baseline quartile of MDS‐ADL scores (0–12)) had a 4.7‐point worsening in their MDS‐ADL scores at 1 year. Functional decline in residents 1 year after surgery was associated with decline in function in the 6 months before surgery (adjusted hazard ratio (aH)=2.39, 95% confidence interval (CI)=2.29–2.49), emergency procedures (aHR=1.37, 95% CI=1.31–1.43), older age (≥85 vs 65–74, aHR=1.17, 95% CI=1.11–1.23), and baseline cognitive impairment (aHR=1.15, 95% CI=1.11–1.20). Conclusion: Despite the low complexity of minor urological procedures, NH residents experience high mortality and many demonstrate sustained functional decline up to 1‐year postoperatively.
- Subjects
UNITED States; UROLOGICAL surgery; MORTALITY; NURSING home patients; GERIATRIC assessment; CONFIDENCE intervals; EVALUATION of medical care; PRE-tests &; post-tests; PROPORTIONAL hazards models; DATA analysis software; DESCRIPTIVE statistics
- Publication
Journal of the American Geriatrics Society, 2018, Vol 66, Issue 5, p909
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.15302