Risk factors for nursing home placement following major nonemergent surgery

Legner, Victor J.; Doerner, Diane; Reilly, Dominic F.; McCormick, W. C.

doi:10.1016/j.accreview.2004.08.081

Cited by 3 publications

(3 citation statements)

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“…Likewise, it has been previously demonstrated that patients with poor functional status and poor pre-operative exercise tolerance had a correlation with discharge to a skilled nursing facility. 27 Frailty was also shown to be a significant predictor of non-home discharge following radical cystectomy. 28 Although in other studies MELD score was significantly associated with mortality after HPB surgery, 29 MELD scores had a non-significant effect on outcomes in most of our multivariate analyses.…”

Section: Discussionmentioning

confidence: 96%

Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery

Windt

Bou‐Samra

Dadashzadeh

et al. 2018

HPB

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Section: Discussionmentioning

confidence: 96%

Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery

Windt

Bou‐Samra

Dadashzadeh

et al. 2018

HPB

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“…Obesity is known to be a risk factor for long-term nursing home placement ( 33 ) . There are some studies which have demonstrated that orthopaedic surgery predicts nursing home placement ( 34 ) , but to the best of our knowledge, no data exist which primarily examine impact of obesity in post-operative elective hip arthroplasty on nursing home placement, particularly with regard to short-term placement. Our results demonstrate that morbidly obese patients were more likely to be discharged to a care facility compared with the other BMI categories following elective arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Impact of body mass on hospital resource use in total hip arthroplasty

Batsis

Naessens

Keegan

et al. 2009

Public Health Nutr.

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Objective: To determine the impact of BMI on post-operative outcomes and resource utilization following elective total hip arthroplasty (THA). Design: A retrospective cohort analysis on all primary elective THA patients between 1996 and 2004. Primary outcomes investigated using regression analyses included length of stay (LOS) and costs (US dollars). Setting: Mayo Clinic Rochester, a tertiary care centre. patients. Overall operative and anaesthesia costs were higher in the morbidly obese group ($5688) than in normal ($5553), overweight ($5549) and obese ($5593) patients (P 5 0?03). Operating room costs were higher in morbidly obese patients ($3418) than in normal ($3276), overweight ($3291) and obese ($3340) patients (P , 0?001). Post-operative costs were no different (P 5 0?30). Blood bank costs differed (P 5 0?002) and were lower in the morbidly obese group ($180) compared with the other patient groups (P , 0?05). Other differences in costs were not significant. Morbidly obese patients were more likely to be transferred to a nursing home (24?1 %) than normal (18?4 %), overweight (17?9 %) or obese (16?0 %) patients (P 5 0?001 each). There were no differences in the composite endpoint of 30 d mortality, re-admissions, re-operations or intensive care unit utilization. Conclusions: BMI in patients undergoing primary elective THA did not impact LOS or overall institutional acute care costs, despite higher operative costs in morbidly obese patients. Obesity does not increase resource utilization for elective THA.

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“…Most studies have focused on the immediate use of post‐acute care after cancer therapy . Our study extends the estimates of post‐acute care use up to 5 years after surgery, examining the long‐term post‐acute care needs in older cancer survivors, demonstrating increased use with age, stage, and the intensity of treatment.…”

Section: Discussionmentioning

confidence: 54%

Post‐Acute Care among Older Adults with Stage I to III Colorectal Cancer

Kenzik

Williams

Bhatia

et al. 2018

J American Geriatrics Society

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BACKGROUND Little information is available on the long‐term use of post‐acute care among older patients with colorectal cancer (CRC), relative to individuals without cancer. This study examines the use of post‐acute care among older cancer survivors (>65 y) with CRC and compares it with noncancer patients up to 5 years from surgery. DESIGN Retrospective cohort. SETTING SEER‐Medicare. PARTICIPANTS Patients treated for stage I to III CRC between January 1, 2000, and December 31, 2011 (n = 40 812) and noncancer Medicare beneficiaries hospitalized for noncancer treatment matching on age, sex, race, comorbidity, and Medicaid dual eligibility. MEASUREMENTS Incident post‐acute care claims (skilled nursing, long‐term care facility, and home health) from 0 to 100 days, 101 to 365 days, and 1 to 5 years from hospitalization. RESULTS The median age was 77 years. All patients had surgery, 34% received chemotherapy, and 27% received surgery and adjuvant therapy. The cumulative incidence of any post‐acute care within 100 days of hospitalization was 45.7% for stage III, 37.9% for stage I/II, and 39% for controls (p < .001). Within the CRC cohort only, the cumulative incidence of post‐acute care was 2.9% (stage I/II) and 4.2% (stage III, p < .001) from 101 to 365 days and 15.8% (stage I/II) and 16.9% (stage III, p < .001) from 1 to 5 years. Increasing age, ostomies, and neoadjuvant or adjuvant therapy were associated with increased hazard of all post‐acute patients within 100 days from hospitalization. From 1 to 5 years from diagnosis, adjuvant therapy was associated with greater exclusive home health care use. CONCLUSIONS Survivorship planning among older CRC patients should include discussions of post‐acute care following cancer therapy, even several years after treatment. J Am Geriatr Soc 67:937–944, 2019.

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Risk factors for nursing home placement following major nonemergent surgery

Cited by 3 publications

References 0 publications

Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery

Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery

Impact of body mass on hospital resource use in total hip arthroplasty

Post‐Acute Care among Older Adults with Stage I to III Colorectal Cancer

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