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Self‐Reported Outcomes in Individuals Aged 65 and Older Admitted for Treatment to an Acute Care Surgical Service: A 6‐Month Prospective Cohort Study
Author(s) -
Ali Talal F.,
Warkentin Lindsey M.,
Gazala Sayf,
Wagg Adrian S.,
Padwal Raj S.,
Khadaroo Rachel G.
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13783
Subject(s) - medicine , prospective cohort study , physical therapy , mcnemar's test , cohort , quality of life (healthcare) , cohort study , acute care , montreal cognitive assessment , barthel index , cognition , population , activities of daily living , gerontology , cognitive impairment , pediatrics , health care , surgery , psychiatry , statistics , mathematics , nursing , environmental health , economics , economic growth
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.