Seniors at high risk for readmission after ambulatory surgery


Patients aged 65 and older who have ambulatory surgery are much more likely to be readmitted to the hospital within 30 days than younger patients, regardless of their health before surgery, reports a national Northwestern Medicine study.

The likely cause, based on previous research, is difficulty understanding medication dosing and discharge instructions, as well as cognitive impairment among older patients.

The study found age is an independent risk factor for ambulatory surgical complications, which was not previously known.

Over a 30-day period, seniors were 54 percent more likely to be readmitted to the hospital compared to patients younger than 65 years, the study reports, after accounting for differences in other medical problems. The problem is likely to worsen as economic pressures to reduce health care costs lead to even more complex surgeries in an ambulatory setting, the authors said.

"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," said corresponding study author Dr Gildasio De Oliveira Jr.

"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."

To prevent costly readmissions, seniors need clearer, more understandable discharge instructions and to be evaluated for their ability to care for themselves after surgery, said De Oliveira, who also is an assistant professor in anesthesiology at Feinberg.

Northwestern Medicine, US, Ambulatory Surgery, Dr Gildasio De Oliveira