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Fall History Predicts Increased Post-Op Complications in Seniors

A fall in the six months prior to surgery also predicts discharge institutionalization, readmission
THURSDAY, Oct. 10 (HealthDay News) -- A history of a fall in the six months prior to elective surgery predicts increased postoperative complications, the need for discharge institutionalization, and 30-day readmission, according to a study published online Oct. 9 in JAMA Surgery.
Teresa S. Jones, M.D., from the University of Colorado in Aurora, and colleagues prospectively studied a cohort of 235 patients aged 65 years and older undergoing elective colorectal and cardiac operations. The authors sought to assess the predictive value of having fallen in the six months prior to the operation on postoperative outcomes.
The researchers found that preoperative falls occurred in one-third of the cohort (mean age, 74 years). In the group with prior falls, one or more postoperative complications occurred more frequently, compared with the non-fallers, independent of advancing chronologic age following both colorectal (59 versus 25 percent) and cardiac (39 versus 15 percent) operations. Compared to non-fallers, in the group with previous falls, the need for discharge to an institutional care facility occurred significantly more frequently for both surgeries. Similarly, 30-day readmission was significantly higher in both surgical groups among patients with prior falls.
"Using a history of prior falls in preoperative risk assessment for an older adult represents a shift from current preoperative assessment strategies," the authors write.
Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1748775#Abstract )Full Text (http://archsurg.jamanetwork.com/article.aspx?articleid=1748775 )Editorial (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1748773 )
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