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Home Return After Surgery in Patients Aged over 85 Years is Associated with Preoperative Albumin Levels, the Type of Surgery, and APACHE II Score

 Bora Lee  ;  Sungwon Na  ;  Miran Park  ;  Sungyeon Ham  ;  Jeongmin Kim 
 WORLD JOURNAL OF SURGERY, Vol.41(4) : 919-926, 2017 
Journal Title
Issue Date
APACHE* ; Aged, 80 and over ; Female ; Hip Joint/surgery ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Patient Discharge* ; Retrospective Studies ; Serum Albumin* ; Surgical Procedures, Operative/statistics & numerical data
Intensive Care Unit ; Intensive Care Unit Admission ; Intensive Care Unit Stay ; Home Return ; Mini Nutritional Assessment Score
BACKGROUND: Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home return (HR), because quality of life is valuable to these patients. We identified predictors for HR of patients aged >85 years admitted to the ICU after surgery.

METHODS: Retrospective analysis of medical records was conducted at a university hospital. Patients aged > 85 years, admitted to the ICU after surgery from March 2006 to June 2015 (n = 187), were divided into a HR group (patients who returned home after discharge) and non-HR group (deceased or transferred to nursing facilities). Perioperative data and outcome were assessed and compared. Multivariate logistic regression analysis was conducted to identify independent predictors.

RESULTS: The average age of patients was 88 years. HR occurred in 61% of patients, and mortality was 9%. The HR group had higher preoperative albumin level than did the non-HR group. More patients in the non-HR group experienced hip surgery than in the HR group (51 vs. 12%, P < 0.001). APACHE II score was higher (P < 0.001) in the non-HR group. In multivariate analysis, preoperative albumin, hip surgery, and APACHE II score were independent predictors of HR.

CONCLUSION: Predictors of HR of surgical critically ill elderly patients included preoperative albumin level, hip surgery, and APACHE II score on ICU admission.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
Park, Miran(박미란)
Lee, Bo Ra(이보라) ORCID logo https://orcid.org/0000-0002-7699-967X
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
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