Self-Reported Outcomes in Individuals Aged 65 and Older Admitted for Treatment to an Acute Care Surgical Service: A 6-Month Prospective Cohort Study

• Autores: Talal F. Ali, Lindsey M. Warkentin, Sayf Gazala, Adrian Wagg, Raj S. Padwal, Rachel G. Khadaroo
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 63, Nº. 11, 2015, págs. 2388-2394
• Idioma: inglés
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• Resumen

  • Objectives To examine health-related quality of life (HRQL) and cognitive and functional status before and after emergency surgical care in elderly adults.

    Design Six-month prospective cohort study.

    Setting Acute care and emergency surgery service at a single, academic tertiary care center, Edmonton, Alberta, Canada.

    Participants Admitted individuals aged 65 and older (mean age 77.8 ± 7.9, 52% female) or their surrogates.

    Measurements Abbreviated Mental Test Score-4 (AMTS), Barthel Index, Vulnerable Elders Survey (VES-13), and EuroQol-5 Dimensional Scale (EQ-5D) completed by participants or their surrogates within 24 hours of admission to the hospital and 6 months after discharge. Paired t-tests and McNemar tests were used to assess the difference between baseline and 6 months.

    Results One hundred fifty-five consecutive individuals (including 16 surrogates) were enrolled. Sixteen (10%) died within 6 months of discharge, and 116 (75%, including 18 surrogates) completed a follow-up assessment 6 months after discharge. Cognitive status improved substantially over 6 months, with 72 (52%) of participants having AMTS scores showing cognitive impairment at baseline and four (4%) having AMTS scores showing cognitive impairment at 6 months (P < .001). There was no statistically significant change from baseline on the Barthel Index, VES-13, or EQ-5D.

    Conclusion There was significant cognitive improvement in older adults after surgical hospitalization. HRQL improved back to age-matched population norms. These results suggest that elderly adults admitted for emergency surgery have good cognitive, functional, and HRQL outcomes.