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Functional status after colon cancer surgery in elderly nursing home residents.
J Am Geriatr Soc. 2012 May; 60(5):967-73.JA

Abstract

OBJECTIVES

To determine functional status and mortality rates after colon cancer surgery in older nursing home residents.

DESIGN

Retrospective cohort study.

SETTING

Nursing homes in the United States.

PARTICIPANTS

Six thousand eight hundred twenty-two nursing home residents aged 65 and older who underwent surgery for colon cancer in the United States between 1999 and 2005.

MEASUREMENTS

Changes in functional status were assessed before and after surgery using the Minimum Data Set Activity of Daily Living (MDS-ADL) summary scale, a 28-point scale in which score increases as functional dependence increases. Regression techniques were used to identify patient characteristics associated with mortality and functional decline 1 year after surgery.

RESULTS

On average, residents who underwent colectomy had a 3.9-point worsening in MDS-ADL score at 1 year. One year after surgery, rates of mortality and sustained functional decline were 53% and 24%, respectively. In multivariate analysis, older age (≥ 80 vs 65-69, adjusted relative risk (ARR) = 1.53, 95% confidence interval (CI) = 1.15-2.04, P < .001), readmission after surgical hospitalization (ARR = 1.15, 95% CI = 1.03-1.29, P = .02), surgical complications (ARR = 1.11, 95% CI = 1.02-1.21, P = .01), and functional decline before surgery (ARR = 1.21, 95% CI = 1.11-1.32, P < .001) were associated with functional decline at 1 year.

CONCLUSION

Mortality and sustained functional decline are common after colon cancer surgery in nursing home residents. Initiatives aimed at improving surgical outcomes are needed in this vulnerable population.

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Authors+Show Affiliations

Finlayson E
Phillip R. Lee Institute of Health Policy Studies, San Francisco, California 94118, USA. emily.finlayson@ucsfmedctr.org
Zhao S
No affiliation info available
Boscardin WJ
No affiliation info available
Fries BE
No affiliation info available
Landefeld CS
No affiliation info available
Dudley RA
No affiliation info available

MeSH

Activities of Daily LivingAgedAged, 80 and overCohort StudiesColonic NeoplasmsFemaleHomes for the AgedHumansMaleNursing HomesRetrospective StudiesSurvival Rate

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22428583

Citation

Finlayson, Emily, et al. "Functional Status After Colon Cancer Surgery in Elderly Nursing Home Residents." Journal of the American Geriatrics Society, vol. 60, no. 5, 2012, pp. 967-73.
Finlayson E, Zhao S, Boscardin WJ, et al. Functional status after colon cancer surgery in elderly nursing home residents. J Am Geriatr Soc. 2012;60(5):967-73.
Finlayson, E., Zhao, S., Boscardin, W. J., Fries, B. E., Landefeld, C. S., & Dudley, R. A. (2012). Functional status after colon cancer surgery in elderly nursing home residents. Journal of the American Geriatrics Society, 60(5), 967-73. https://doi.org/10.1111/j.1532-5415.2012.03915.x
Finlayson E, et al. Functional Status After Colon Cancer Surgery in Elderly Nursing Home Residents. J Am Geriatr Soc. 2012;60(5):967-73. PubMed PMID: 22428583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional status after colon cancer surgery in elderly nursing home residents. AU - Finlayson,Emily, AU - Zhao,Shoujun, AU - Boscardin,W John, AU - Fries,Brant E, AU - Landefeld,C Seth, AU - Dudley,R Adams, Y1 - 2012/03/16/ PY - 2012/3/21/entrez PY - 2012/3/21/pubmed PY - 2012/7/17/medline SP - 967 EP - 73 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 60 IS - 5 N2 - OBJECTIVES: To determine functional status and mortality rates after colon cancer surgery in older nursing home residents. DESIGN: Retrospective cohort study. SETTING: Nursing homes in the United States. PARTICIPANTS: Six thousand eight hundred twenty-two nursing home residents aged 65 and older who underwent surgery for colon cancer in the United States between 1999 and 2005. MEASUREMENTS: Changes in functional status were assessed before and after surgery using the Minimum Data Set Activity of Daily Living (MDS-ADL) summary scale, a 28-point scale in which score increases as functional dependence increases. Regression techniques were used to identify patient characteristics associated with mortality and functional decline 1 year after surgery. RESULTS: On average, residents who underwent colectomy had a 3.9-point worsening in MDS-ADL score at 1 year. One year after surgery, rates of mortality and sustained functional decline were 53% and 24%, respectively. In multivariate analysis, older age (≥ 80 vs 65-69, adjusted relative risk (ARR) = 1.53, 95% confidence interval (CI) = 1.15-2.04, P < .001), readmission after surgical hospitalization (ARR = 1.15, 95% CI = 1.03-1.29, P = .02), surgical complications (ARR = 1.11, 95% CI = 1.02-1.21, P = .01), and functional decline before surgery (ARR = 1.21, 95% CI = 1.11-1.32, P < .001) were associated with functional decline at 1 year. CONCLUSION: Mortality and sustained functional decline are common after colon cancer surgery in nursing home residents. Initiatives aimed at improving surgical outcomes are needed in this vulnerable population. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/22428583/Functional_status_after_colon_cancer_surgery_in_elderly_nursing_home_residents_ L2 - https://doi.org/10.1111/j.1532-5415.2012.03915.x DB - PRIME DP - Unbound Medicine ER -