LATE MOBILIZATION IN ELDERLY SURGICAL PATIENTS PREDICTS READMISSION OR DEATH AFTER DISCHARGE
Acute surgical services are increasingly treating seniors with complex care needs who are at high risk for hospital readmission and functional decline. Yet, the prognostic importance of early post-operative mobilization remains unclear. We investigated whether time to post-operative mobilization amo...
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| Veröffentlicht in: | Innovation in aging 2017-07, Vol.1 (suppl_1), p.4-4 |
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| creator | Pederson, J.L. Padwal, R.S. Warkentin, L. Holroyd-Leduc, J. Wagg, A. Khadaroo, R.G. |
| description | Acute surgical services are increasingly treating seniors with complex care needs who are at high risk for hospital readmission and functional decline. Yet, the prognostic importance of early post-operative mobilization remains unclear. We investigated whether time to post-operative mobilization among older surgical patients predicts readmission or death. Mobilization after emergency abdominal surgery in a prospective cohort of patients aged ≥ 65 years requiring help pre-operatively with < 3 activities of daily living were followed after discharge from 2 Canadian tertiary-care hospitals. Late mobilization was defined as ≥ 36 hours following surgery. The primary outcome was 30-day all-cause readmission or death. Patients (N=306) had a mean age of 76 ± 7.7 years, 55% were women, 41% were vulnerable-to-moderately frail. Gallstones (23%), intestinal obstruction (21%), or hernia (17%) were the most common reasons for admission. Twenty-four percent were mobilized ≥ 36 hours after surgery. Late mobilized patients were more often readmitted or died within 30-days [19 (26%)
vs
22 (10%), p |
| doi_str_mv | 10.1093/geroni/igx004.012 |
| format | Article |
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vs
22 (10%), p<0.001] and within 6-months [38 (51%)
vs
64 (28%), p<0.001], compared to early mobilized patients. Late mobilization remained associated with increased risk of readmission or death within 30-days [adjusted odds ratio (aOR) 2.50, 95%CI 1.16–5.40, p=0.02] and at 6-months (aOR 1.85, 95%CI 0.99–3.5, p=0.055) in multivariable logistic regression adjusting for age, sex, comorbidities, total medications, hemoglobin, and frailty. Late mobilization is common in elderly patients following emergency abdominal surgery and identifies heighted risk of readmission or death after discharge. Interventions targeted at early mobilization may decrease risk for adverse events in this vulnerable population.</description><identifier>ISSN: 2399-5300</identifier><identifier>EISSN: 2399-5300</identifier><identifier>DOI: 10.1093/geroni/igx004.012</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Abstracts</subject><ispartof>Innovation in aging, 2017-07, Vol.1 (suppl_1), p.4-4</ispartof><rights>The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241464/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241464/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27922,27923,53789,53791</link.rule.ids></links><search><creatorcontrib>Pederson, J.L.</creatorcontrib><creatorcontrib>Padwal, R.S.</creatorcontrib><creatorcontrib>Warkentin, L.</creatorcontrib><creatorcontrib>Holroyd-Leduc, J.</creatorcontrib><creatorcontrib>Wagg, A.</creatorcontrib><creatorcontrib>Khadaroo, R.G.</creatorcontrib><title>LATE MOBILIZATION IN ELDERLY SURGICAL PATIENTS PREDICTS READMISSION OR DEATH AFTER DISCHARGE</title><title>Innovation in aging</title><description>Acute surgical services are increasingly treating seniors with complex care needs who are at high risk for hospital readmission and functional decline. Yet, the prognostic importance of early post-operative mobilization remains unclear. We investigated whether time to post-operative mobilization among older surgical patients predicts readmission or death. Mobilization after emergency abdominal surgery in a prospective cohort of patients aged ≥ 65 years requiring help pre-operatively with < 3 activities of daily living were followed after discharge from 2 Canadian tertiary-care hospitals. Late mobilization was defined as ≥ 36 hours following surgery. The primary outcome was 30-day all-cause readmission or death. Patients (N=306) had a mean age of 76 ± 7.7 years, 55% were women, 41% were vulnerable-to-moderately frail. Gallstones (23%), intestinal obstruction (21%), or hernia (17%) were the most common reasons for admission. Twenty-four percent were mobilized ≥ 36 hours after surgery. Late mobilized patients were more often readmitted or died within 30-days [19 (26%)
vs
22 (10%), p<0.001] and within 6-months [38 (51%)
vs
64 (28%), p<0.001], compared to early mobilized patients. Late mobilization remained associated with increased risk of readmission or death within 30-days [adjusted odds ratio (aOR) 2.50, 95%CI 1.16–5.40, p=0.02] and at 6-months (aOR 1.85, 95%CI 0.99–3.5, p=0.055) in multivariable logistic regression adjusting for age, sex, comorbidities, total medications, hemoglobin, and frailty. Late mobilization is common in elderly patients following emergency abdominal surgery and identifies heighted risk of readmission or death after discharge. Interventions targeted at early mobilization may decrease risk for adverse events in this vulnerable population.</description><subject>Abstracts</subject><issn>2399-5300</issn><issn>2399-5300</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNpVkNtKw0AURQdRsNR-gG_zA2nPXJJpXoSYTNuBtClJ-qAIQy6TGumNREX_3tSI6NPZnM1eDwuhWwJjAi6bbE1zPNSTevsBwMdA6AUaUOa6ls0ALv_kazRq2xcAIC7jLqcD9BR6qcTL6F6F6tFLVbTCaoVlGMg4fMDJJp4r3wvxuqvkKk3wOpaB8rsQSy9YqiQ5L6IYB9JLF9ibpbLLKvEXXjyXN-iqynatGf3cIdrMZOovrDD6xloF4UAtalNOK1FQI0oBNqOFLUowRVZNK0dUAFNBXJI7xuketGJE5DlnNCdlJoxbGjZEdz339JbvTVmYw2uT7fSpqfdZ86mPWa3_N4f6WW-P79qhnHCHdwDSA4rm2LaNqX63BPRZse4V616x7hSzL5VBa0U</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Pederson, J.L.</creator><creator>Padwal, R.S.</creator><creator>Warkentin, L.</creator><creator>Holroyd-Leduc, J.</creator><creator>Wagg, A.</creator><creator>Khadaroo, R.G.</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20170701</creationdate><title>LATE MOBILIZATION IN ELDERLY SURGICAL PATIENTS PREDICTS READMISSION OR DEATH AFTER DISCHARGE</title><author>Pederson, J.L. ; Padwal, R.S. ; Warkentin, L. ; Holroyd-Leduc, J. ; Wagg, A. ; Khadaroo, R.G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1402-25242f7c2e7d70532c57d0ecaf8f67f0087191b6e6f8f2f317bb432b1da7e9de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abstracts</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pederson, J.L.</creatorcontrib><creatorcontrib>Padwal, R.S.</creatorcontrib><creatorcontrib>Warkentin, L.</creatorcontrib><creatorcontrib>Holroyd-Leduc, J.</creatorcontrib><creatorcontrib>Wagg, A.</creatorcontrib><creatorcontrib>Khadaroo, R.G.</creatorcontrib><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Innovation in aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pederson, J.L.</au><au>Padwal, R.S.</au><au>Warkentin, L.</au><au>Holroyd-Leduc, J.</au><au>Wagg, A.</au><au>Khadaroo, R.G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>LATE MOBILIZATION IN ELDERLY SURGICAL PATIENTS PREDICTS READMISSION OR DEATH AFTER DISCHARGE</atitle><jtitle>Innovation in aging</jtitle><date>2017-07-01</date><risdate>2017</risdate><volume>1</volume><issue>suppl_1</issue><spage>4</spage><epage>4</epage><pages>4-4</pages><issn>2399-5300</issn><eissn>2399-5300</eissn><abstract>Acute surgical services are increasingly treating seniors with complex care needs who are at high risk for hospital readmission and functional decline. Yet, the prognostic importance of early post-operative mobilization remains unclear. We investigated whether time to post-operative mobilization among older surgical patients predicts readmission or death. Mobilization after emergency abdominal surgery in a prospective cohort of patients aged ≥ 65 years requiring help pre-operatively with < 3 activities of daily living were followed after discharge from 2 Canadian tertiary-care hospitals. Late mobilization was defined as ≥ 36 hours following surgery. The primary outcome was 30-day all-cause readmission or death. Patients (N=306) had a mean age of 76 ± 7.7 years, 55% were women, 41% were vulnerable-to-moderately frail. Gallstones (23%), intestinal obstruction (21%), or hernia (17%) were the most common reasons for admission. Twenty-four percent were mobilized ≥ 36 hours after surgery. Late mobilized patients were more often readmitted or died within 30-days [19 (26%)
vs
22 (10%), p<0.001] and within 6-months [38 (51%)
vs
64 (28%), p<0.001], compared to early mobilized patients. Late mobilization remained associated with increased risk of readmission or death within 30-days [adjusted odds ratio (aOR) 2.50, 95%CI 1.16–5.40, p=0.02] and at 6-months (aOR 1.85, 95%CI 0.99–3.5, p=0.055) in multivariable logistic regression adjusting for age, sex, comorbidities, total medications, hemoglobin, and frailty. Late mobilization is common in elderly patients following emergency abdominal surgery and identifies heighted risk of readmission or death after discharge. Interventions targeted at early mobilization may decrease risk for adverse events in this vulnerable population.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/geroni/igx004.012</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| title | LATE MOBILIZATION IN ELDERLY SURGICAL PATIENTS PREDICTS READMISSION OR DEATH AFTER DISCHARGE |
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