Senior living: Should older seniors risk major surgery? New research offers guidance

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Patients 65 and older undergo nearly 40% of all surgeries in the United States, but data on outcomes has been limited.

Nearly 1 in 7 older adults die within a year of undergoing major surgery, according to an importantEspecially vulnerable are older patients with probable dementia and frailty , as well as those having emergency surgeries . Advanced age also amplifies risk: Patients who were 90 or older were six times as likely to die than those ages 65 to 69.

Of particular importance is information about how many seniors die, develop disabilities, can no longer live independently, or have a significantly worsened quality of life after major surgery. Invasive procedures that take place in operating rooms with patients under general anesthesia were counted as major surgeries. Examples include procedures to replace broken hips, improve blood flow in the heart, excise cancer from the colon, remove gallbladders, fix leaky heart valves and repair hernias, among many more.

As an example of this kind of decision-making, Ko described a patient who, at 93, learned he had early-stage colon cancer on top of preexisting liver, heart and lung disease. After an in-depth discussion and being told that the risk of poor results was high, the patient decided against invasive treatment.

 

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