Almost 14 percent of older adults die soon after receiving major surgery. They face life-threatening risks from surgery, according to a new study. Judith Graham reports for Kaiser Health News on the cohort of older adults who are most likely to die from surgery.
Frail and demented older adults, as well as older adults having unplanned surgeries, and those over 90 are most at risk. Older adults with multiple chronic conditions, along with those who are not fully independent going into surgery, are also at serious risk. In addition, people with cognitive issues are more likely to die post surgery.
Inexcusably, though the Medicare population represents about 40 percent of the surgery population, there is little national data on surgery outcomes. Surgeries include cancer tumor removal, gallbladder removal, heart and hernia repairs, hip replacements and much more.
In addition to a high risk of death from surgery, many older adults become disabled, lose their independence or experience a decline in quality of life post surgery. Why doesn’t Medicare collect this data?
The researchers found that, six months post surgery, as many as one third of older adults are not as functional as they were when they went in for surgery. Those who rebounded most quickly were older adults who had planned ahead for their surgeries.
We are left wondering when surgeries performed on people over 65 are appropriate and how many surgeries are undertaken without weighing the risks or engaging the patients? It’s also not clear how many surgery patients are instructed on planning ahead for surgery. People going into surgery should, to the extent possible, prepare themselves and strengthen their bodies, through physical activity and high-protein diets.
With the population aging, Medicare costs could rise significantly as a result of more surgeries performed. However, there are projected to be 30,000 fewer surgeons over the next decade than the US will need to meet demand. In addition, hospitals are ill-prepared to meet the needs of older patients getting surgery; the overwhelming majority of hospitals are not participating in a national effort to meet standards for expertise in geriatric surgery.
Hospitals that are prepared to treat geriatric patients generally will assess them for delirium post surgery, ensure they are engaging in physical activity, and avoid giving them narcotic pain medicines. These three things can reduce the risks of post-surgical harm.
The researchers relied on traditional Medicare data for their study because Medicare Advantage data was unavailable.
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