What Factors Predict Adverse Discharge Disposition in Patients Older Than 60 Years Undergoing Lower-extremity Surgery? The Adverse Discharge in Older Patients after Lower-extremity Surgery (ADELES) Risk Score.

Clinical Orthopaedics and Related Research
Maximilian S SchaeferMatthias Eikermann

Abstract

Adverse discharge disposition, which is discharge to a long-term nursing home or skilled nursing facility is frequent and devastating in older patients after lower-extremity orthopaedic surgery. Predicting individual patient risk allows for preventive interventions to address modifiable risk factors and helps managing expectations. Despite a variety of risk prediction tools for perioperative morbidity in older patients, there is no tool available to predict successful recovery of a patient's ability to live independently in this highly vulnerable population. In this study, we asked: (1) What factors predict adverse discharge disposition in patients older than 60 years after lower-extremity surgery? (2) Can a prediction instrument incorporating these factors be applied to another patient population with reasonable accuracy? (3) How does the instrument compare with other predictions scores that account for frailty, comorbidities, or procedural risk alone? In this retrospective study at two competing New England university hospitals and Level 1 trauma centers with 673 and 1017 beds, respectively; 83% (19,961 of 24,095) of patients 60 years or older undergoing lower-extremity orthopaedic surgery were included. In all, 5% (1316 of 2...Continue Reading

References

Mar 17, 2001·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·L P FriedUNKNOWN Cardiovascular Health Study Collaborative Research Group
Jan 18, 2006·American Journal of Epidemiology·Neil J Perkins, Enrique F Schisterman
Jun 8, 2006·Age and Ageing·Darryl B RolfsonKenneth Rockwood
Sep 5, 2006·The Journal of Arthroplasty·Kevin J BozicHarry E Rubash
Apr 22, 2008·Journal of the American Geriatrics Society·Jane L GivensEdward R Marcantonio
Apr 26, 2008·Biometrical Journal. Biometrische Zeitschrift·Marcus D RuoppEnrique F Schisterman
Apr 2, 2009·BMJ : British Medical Journal·Patrick RoystonYvonne Vergouwe
Apr 8, 2010·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·Claire Noël-Miller
Aug 19, 2010·Clinical Orthopaedics and Related Research·R Allen ButlerRobert L Barrack
May 24, 2011·BMC Musculoskeletal Disorders·Jorma PanulaSirkka-Liisa Kivelä
Oct 30, 2013·Clinical Orthopaedics and Related Research·Kushal V PatelMatthew L Davis
Jan 21, 2014·Journal of the American College of Surgeons·Joseph A HyderLouis L Nguyen
Oct 29, 2015·JAMA Surgery·Mark D Neuman, Rachel M Werner
May 24, 2016·Journal of the American College of Surgeons·Yaoming LiuKarl Y Bilimoria
Sep 4, 2016·BMC Geriatrics·Suzanne M DyerUNKNOWN Fragility Fracture Network (FFN) Rehabilitation Research Special Interest Group
Oct 7, 2016·Lancet·Stefan J SchallerUNKNOWN International Early SOMS-guided Mobilization Research Initiative
Nov 18, 2016·International Psychogeriatrics·Andrea Luise KoppitzLorenz Imhof
Dec 21, 2016·Clinical Orthopaedics and Related Research·Jaiben GeorgeCarlos A Higuera
Oct 27, 2017·Journal of the American Geriatrics Society·Daniel E LageSachin J Shah
Nov 21, 2017·Journal of the American College of Surgeons·Sneha SubramaniamCelia M Divino
Aug 15, 2018·Journal of Huntington's Disease·Jessica Y WinderRaymund A C Roos
Sep 12, 2018·The Journal of Arthroplasty·David N BernsteinKevin J Bozic
Sep 23, 2018·European Urology·Ben Van CalsterEwout W Steyerberg
Oct 6, 2018·Journal of the American Medical Directors Association·Jose M CancioDomingo Ruiz
Oct 12, 2018·Clinical Orthopaedics and Related Research·Abigail Y WangCasey Jo Humbyrd
Dec 6, 2018·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Sang Yoon LeeJae-Young Lim
Jan 8, 2019·Clinical Orthopaedics and Related Research·Michael C FuJonathan N Grauer
Jan 23, 2019·Intensive Care Medicine·Stefan J SchallerMatthias Eikermann
Jan 29, 2019·Annals of Internal Medicine·Desiree WusslerChristian Mueller
Jun 9, 2019·BMC Public Health·Venicius Dantas da SilvaJair Sindra Virtuoso
Jun 19, 2019·Clinical Orthopaedics and Related Research·Alexander M LieberShyam Brahmabhatt
Aug 8, 2019·Clinical Orthopaedics and Related Research·Jacob M WilsonGeorge N Guild
Nov 2, 2019·Journal of the American College of Surgeons·Abhinav B SinghRobert A Meguid
Apr 21, 2020·Clinical Orthopaedics and Related Research·Nicholas M RabahRandall E Marcus
May 20, 2020·Anesthesia and Analgesia·Bijan TejaMatthias Eikermann
Aug 11, 2020·The Journal of Surgical Research·Heather CarmichaelCatherine G Velopulos

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