Evaluating the Association of Preoperative Functional Status and Postoperative Functional Decline in Older Patients Undergoing Major Surgery

DOI Web Site 被引用文献2件
  • Steve Kwon
    Department of Surgery, University of Washington, Seattle, Washington;
  • Rebecca Symons
    Department of Surgery, University of Washington, Seattle, Washington;
  • Michi Yukawa
    Department of Medicine/Division of Geriatrics, University of California, San Francisco, San Francisco, California
  • Nikolas Dasher
    Department of Medicine/Division of Geriatrics, University of California, San Francisco, San Francisco, California
  • Victor Legner
    Department of Geriatric Medicine, University of California, San Diego, San Diego, California
  • David R. Flum
    Department of Surgery, University of Washington, Seattle, Washington;

書誌事項

公開日
2012-12
権利情報
  • https://journals.sagepub.com/page/policies/text-and-data-mining-license
DOI
  • 10.1177/000313481207801225
公開者
SAGE Publications

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説明

<jats:p>This prospective cohort study sought to identify predictors of functional decline in patients aged 65 years or older who underwent major, nonemergent abdominal or thoracic surgery in our tertiary hospital from 2006 to 2008. We used the Stanford Health Assessment Questionnaire–Disability Index (HAQ-DI) to evaluate functional decline; a 0.1 or greater increase was used to indicate a clinically significant decline. The preoperative Duke Activity Status Index (DASI) and a physical function score (PFS), assessing gait speed, grip strength, balance, and standing speed, were evaluated as predictors of decline. We enrolled 215 patients (71.2 ± 5.2 years; 56.7% female); 204 completed follow-up HAQ assessments (71.1 ± 5.3 years; 57.8% female). A significant number of patients had functional decline out to 1 year. Postoperative HAQ-DI increases of 0.1 or greater occurred in 45.3 per cent at 1 month, 30.1 per cent at 3 months, and 28.3 per cent at 1 year. Pre-operative DASI and PFS scores were not predictors of functional decline. Male sex at 1 month (odds ratio [OR], 3.05; 95% confidence interval [CI], 1.41 to 6.85); American Society of Anesthesiologists class (OR, 3.41; 95% CI, 1.31 to 8.86), smoking (OR, 3.15; 95% CI, 1.27 to 7.85), and length of stay (OR, 1.09; 95% CI, 1.01 to 1.16) at 3 months; and cancer diagnosis at 1 year (OR, 2.6; 95% CI, 1.14 to 5.96) were associated with functional decline.</jats:p>

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