Frail and elderly individuals are more likely to be readmitted to a hospital following an outpatient procedure, according to the findings of new research, which recommends additional screening and interventions to reduce the risk of complications.
In a study published late last month in the medical journal JAMA Network Open, Stanford researchers report that frail patients are twice as likely to need to return to the hospital after an elective outpatient surgery when compared to other patients who are the same age, but stronger.
Researchers analyzed data for nearly 420,000 geriatric patients in the National Surgical Quality Improvement Program. Patients underwent elective outpatient surgical procedures from 2012 to 2013, and either were discharged the same day or stayed one or more days.
Among all patients, frail patients were more likely to have unplanned readmission to the hospital compared to non-frail patients, regardless of how many days the patient stayed. Similarly, frailty was independently linked to readmission and linked to readmission when mediated by complications.
Researchers define frailty as a “syndrome of increased vulnerability to a stressor, which can disrupt physiological homeostasis and degrade health status.” Frail patients are harder to resuscitate after death and tend to face higher rates of other complications.
Since the findings suggest that frailty is a significant risk factor for readmission after an elective outpatient surgery, researchers indicate that screening may result in the development of better interventions that would decrease the need for unplanned hospital readmission.
Signs of frailty include recent dramatic weight loss, poor grip strength, tendency toward falls, and other factors that indicate a person may be more frail. Researchers noted these factors may also indicate a person who undergoes outpatient surgery will be more likely to need to return to the hospital due to complications.
Prior studies have shown a link between frail patients and readmission rates in an inpatient hospital setting, but not much research has been conducted regarding frailty and readmissions in outpatient procedures.
Frail patients were also more likely to get surgical site infections, have gastrointestinal complications, and have abnormal bleeding. They were also more likely to be hospitalized for renal complications, neurologic complications, cancer, cardiac complications, orthopedic complications, or pulmonary complications.
The new research indicates surgical patients may benefit if surgeons screen for frailty to decrease complications and unplanned readmissions after surgery.