Document Detail

Evaluating the association of preoperative functional status and postoperative functional decline in older patients undergoing major surgery.
MedLine Citation:
PMID:  23265122     Owner:  NLM     Status:  MEDLINE    
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. Preoperative 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.
Steve Kwon; Rebecca Symons; Michi Yukawa; Nikolas Dasher; Victor Legner; David R Flum
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American surgeon     Volume:  78     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-25     Completed Date:  2013-03-01     Revised Date:  2014-11-12    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1336-44     Citation Subset:  IM    
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MeSH Terms
Activities of Daily Living
Age Factors
Cohort Studies
Confidence Intervals
Digestive System Surgical Procedures / adverse effects,  methods
Disability Evaluation*
Exercise Tolerance / physiology*
Geriatric Assessment / methods
Health Status*
Odds Ratio
Physical Fitness / physiology*
Postoperative Period
Preoperative Period
Prospective Studies
Quality of Life*
Recovery of Function
Risk Assessment
Sex Factors
Thoracic Surgical Procedures / adverse effects,  methods
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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