A large national study suggests that patients age 65 and older could be at high risk for readmission to the hospital within 30 days after ambulatory surgery, regardless of their health prior to the surgery.
The reasons, the study suggests, are medication errors, confusion about medication dosing and discharge instructions, and cognitive impairment among older patients, according to a news release from Northwestern University.
Age is an independent risk factor for ambulatory surgical complications, which was not previously known, the release continues.
Per the study, published in the August issue of the Journal of the American Geriatrics Society, researchers at Northwestern University examined data from 53,667 patients who underwent ambulatory surgery in academic medical centers. The authors used the 2012 National Surgical Quality Improvement Program data set, the release explains.
The study found that over a 30-day period, seniors were 54% more likely to be readmitted to the hospital compared to patients younger than 65 years, after accounting for differences in other medical problems, according to the release.
“These seniors were supposed to stay out of the hospital since the procedures were performed in the ambulatory setting, but they were admitted to the hospital within 30 days,” says corresponding study author Gildasio De Oliveira, Jr, MD, in the release.
“Age was the biggest factor associated with readmission and complications. It’s not because they are sicker, it’s because they are older and have trouble understanding their discharge instructions and medication dosing, which often are not clearly explained,” adds De Oliveira, an assistant professor at the Center for Healthcare Studies at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital, in the release.
Seniors may have difficulty understanding how medicine is prescribed and take too much or too little. Undertaking pain medication can lead to cardiovascular problems and poor healing of the wound, in addition to increased pain, De Oliveira notes in the release.
He adds in the release that seniors’ low health literacy is not necessarily related to education level or socio-economic status.
De Oliveira believes a possible solution is to design clearer discharge instructions tailored to seniors.
“Before allowing patients to get ambulatory surgery, surgeons also should verify if patients are able to take care of themselves at home, and if they have support,” De Oliveira states in the release.
“If not, patients should be admitted to the hospital after surgery or have some type of formal support by a nurse to help them at home,” he concludes.
[Source(s): Northwestern University, Science Daily]