Home E-Weekly July 19, 2016

Loss of Independence Signals Readmission Risks

Published: July 18, 2016

Loss of independence after surgery occurs more frequently as patients get older. It also puts them at greater risk of hospital readmission, according to a study in JAMA Surgery.

The study's authors define loss of independence as a decline in function or mobility, an increased need for in-home care or a discharge to a non-home destination after surgery.

They analyzed 5,000 patients undergoing inpatient surgery and found the condition increased with age. Loss of independence occurred in 50% of patients aged 65 to 74, in 67% of patients aged 75 to 84, and in 84% of patients aged 85 years and older. It follows only serious post-op complications as a risk factor for readmission, increasing the risk by 70%. Patients suffering post-op loss of independence also see an increased mortality risk.

"Patient-centered outcomes such as loss of independence can, and should, be collected in multi-institutional data registries," say the study's authors. "Loss of independence is a potential target for intervention, and future work should move beyond its use as a factor for prognostication. To best serve the aging population, clinical initiatives must focus on efforts to minimize loss of independence and better understand its association with discrete outcomes like readmission and death after discharge."

Kendal Gapinski

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