Surgical Complications From Falling

(From JAMA)

Surgical complications from falling increase if you have fallen six months prior to surgery, no doubt a result of a weakened physical state.

According to a JAMA article, a history of one or more falls in the six months before a surgery appears to be an indicator of complications, the need to be discharged to a care facility and 30-day readmission after a surgery, according to a study by Teresa S. Jones, M.D., of the University of Colorado School of Medicine, Aurora, and colleagues.

More than one-third of all U.S. inpatient operations are performed on patients 65 years and older, a proportion which will increase during the next several decades. Existing preoperative risk assessment strategies do not quantify the risk that comes from being frail, according to the study background.

Researchers sought to evaluate the relationship between older patients with a history of falls (a measure of frailty) in the preceding six months of a major elective operation and postoperative outcomes. The study included 235 patients (average age 74 years) undergoing elective colorectal and cardiac operations. Thirty-three percent of patients had preoperative falls.

Postoperative complications occurred more frequently in the group with prior falls compared to those patients who had not fallen following both colorectal (59 percent vs. 25 percent) and cardiac (39 percent vs. 15 percent) operations, according to the study findings. The need to be discharged to a care facility also occurred more frequently in the group that had fallen and 30-day readmission was higher.

‰ÛÏGiven the high volume of surgical care provided for the elderly population, improving preoperative risk assessment for the older adult is becoming increasingly important. Incorporating geriatric-specific variables that reflect physiologic vulnerability of the older adult into large surgical outcomes data sets used to construct preoperative risk calculators has real potential to improve the accuracy of these tools at forecasting risk in older adults ‰Û the study concludes.

Do This: Talk to your physician / surgeon and specifically report any falls and consider postponing surgery if possible until your health improves.

Not That: Do not selectively forget to mention this to your physician. Don’t put yourself at risk by having a surgery whose risks could be complicated by a recent fall.