Age is not a risk factor for complications after surgery among older patients

January 12, 2018, St. Michael's Hospital

Among older patients, frailty and cognitive impairment before surgery are associated with developing complications after surgery, but age is not, a new study suggests.

In addition to frailty, depressive symptoms and smoking were also associated with developing postoperative complications following elective surgery, according to the systematic review, published online today in the journal BMC Medicine.

Researchers at St. Michael's Hospital also found that a patient's American Society of Anesthesiologists status, which evaluates the physical health of a patient before surgery and is traditionally assessed as a risk factor for postoperative complications, was not associated with postoperative complications in older .

"The fact that age and ASA status were not for postoperative complications is somewhat surprising, because these are the factors a clinician would typically look at when assessing a patient's risk of developing complications after surgery," said Dr. Jennifer Watt, lead author of the study.

The review examined 44 existing studies including more than 12,000 patients 60 years and older and reporting on postoperative outcomes including complications, postoperative mortality, length of hospitalization, functional decline and whether patients were discharged home or to another hospital or long-term care facility.

Due to significant differences in the design and reporting methods of the included studies, the authors were unable to report on the level of risk for specific postoperative complications, or their severity.

The researchers found that across all studies, 25 per cent of older patients experienced some complications following elective surgery.

"Older adults are a diverse group of patients whose risk of postoperative complications is not solely defined by their age, comorbidities or the type of surgical procedure they receive," said Dr. Watt. "This study highlights how common postoperative complications are among older adults undergoing elective surgery, and the importance of geriatric syndromes, including frailty, in identifying older adults who may be at risk."

The review did not examine why frailty was associated with negative outcomes following surgery, but the authors hypothesize that frailty and not older age was associated with postoperative complications because frailty represents a patient's biological age as opposed to their chronological age.

The authors also noted that there are proven interventions for a number of the risk factors identified in the review. Interventions aimed at improving a patient's nutrition, physical fitness and cognition have been found to improve in older patients, and smoking cessation interventions before surgery have been associated with a lower risk of complications, according to the review.

"With this population, there is potential to intervene to improve outcomes following surgery by identifying and addressing risk factors before surgery, in particular with risk factors like smoking and ," said Dr. Watt. "These factors could be targeted in the preoperative clinic, potentially leading to better outcomes for older adults undergoing elective ."

Explore further: Self-reported function IDs post-op course in elderly

Related Stories

Self-reported function IDs post-op course in elderly

September 25, 2017
(HealthDay)—Self-reported function is more informative than frailty phenotype in predicting a negative postoperative course in older adults, according to a study published online Sept. 19 in the Journal of the American ...

Multidimensional frailty score helps predict postoperative outcomes in older adults

May 7, 2014
A multidimensional frailty score may help predict postoperative outcomes in older adults.

Frailty associated with increased risk of complications following common, outpatient operations

October 11, 2017
Frailty was associated with an increased risk of complications among patients who underwent outpatient hernia, breast, thyroid or parathyroid surgery, with the findings suggesting that surgeons should consider frailty rather ...

Complete handover of anesthesia care may up complications

January 10, 2018
(HealthDay)—Complete handover of intraoperative anesthesia care is associated with an increased risk of adverse postoperative outcomes among adults undergoing major surgery, according to a study published in the Jan. 9 ...

Factors for higher risk of death following hip fracture surgery than hip replacement

September 15, 2015
Patients undergoing surgery for a hip fracture were older and had more medical conditions than patients who underwent an elective total hip replacement, factors that may contribute to the higher risk of in-hospital death ...

Frailty may increase complication risk following urologic surgery

January 19, 2016
For patients undergoing urologic surgery, frailty may increase their risk of experiencing complications after surgery.

Recommended for you

Blood stored longer may be less safe for patients with massive blood loss and shock

March 10, 2018
Human blood from donors can be stored for use up to 42 days, and it is a mainstay therapy in transfusion medicine. However, recent studies looking back at patient records have shown that transfusion with older, stored blood ...

After knee replacement, play on

March 8, 2018
(HealthDay)—Knee replacement patients can continue to enjoy sports—such as skiing, tennis and dancing—without worrying that high-impact activities might compromise their new joint, a small, new study finds.

Engineered cartilage template to heal broken bones

March 8, 2018
A team of UConn Health researchers has designed a novel, hybrid hydrogel system to help address some of the challenges in repairing bone in the event of injury. The UConn Health team, led by associate professor of orthopedic ...

Treating hypothyroidism to stop a stubborn surgical complication

March 7, 2018
Researchers at the University of Michigan have discovered a link between low thyroid hormone levels and wound healing complications.

Neurocognitive impairment linked to worse outcomes after total joint replacement

March 6, 2018
People with undiagnosed neurocognitive deficits are undergoing hip and knee replacements at high rates and are more likely to have poorer short-term outcomes after surgery, according to new research led by orthopedic surgeons ...

Minimally invasive surgeries underused in older patients, new study finds

March 5, 2018
A study of more than 200,000 Medicare patients who had common surgical procedures shows that, compared to the general population, they underwent far fewer minimally invasive operations, whose benefits include lower rates ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.