Owodunni et al identified factors associated with a loss of independence following surgery for an adult >= 65 years of age. These can help to identify a patient who may benefit from more aggressive management or an alternative therapy. The authors are from Johns Hopkins University and University of Hawaii.
Patient selection: surgical patient >= 65 years of age
Loss of independence: discharge destination other than home
Predictors of a loss of independence:
(1) preoperative frailty (Edmonton Frail Scale >=6, over range from 0 to 17)
(2) social dependency (lack of social support and/or dependent in 1 or more activities of daily living)
(3) depression
(4) limited mobility (Timed Get-up and Go > 10 seconds)
(5) Operative Severity Score >= 3 (over range from 1 to 5)
(6) CMS Hierarchical Condition Category >= 1
(7) recent weight loss
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