Activity of daily living improvement after cataract surgery for patients in nursing care facilities

BACKGROUNDWhether the improvement in activities of daily living (ADL) after cataract surgery in patients from nursing care facilities is comparable with that in patients from home remains unclear.METHODSData of patients who underwent cataract surgery from April 2014 to March 2015 were extracted from a national inpatient database in Japan. We identified 222,883 patients hospitalized from home and 1,228 patients hospitalized from nursing care facilities who underwent cataract surgery during hospitalization. A retrospective matched-pair cohort study was performed to compare the proportion of patients with improved ADL after cataract surgery. The primary outcome was the proportion of patients with improved ADL after cataract surgery. ADL assessment was performed by calculating the Barthel index. We also compared the length of hospital stay between the groups.RESULTSPatients from nursing care facilities were more likely to be older and female and to have a higher comorbidity index and lower ADL score at admission. In the matched-pair analysis of 1,228 vs. 24,560 pairs, a lower proportion of patients hospitalized from nursing care facilities had an improved ADL score (odds ratio, 0.64; 95% confidence interval, 0.53–0.78; p < 0.001). There was no significant difference in the length of hospital stay between the groups.CONCLUSIONSIn this large nationwide cohort of patients with cataracts, hospitalization from nursing homes was significantly correlated with poor improvement in ADL compared with hospitalization from home. These results suggest that early cataract surgery prior to admission to nursing care facilities should be recommended for patients with cataracts.