One-Year Mortality 13.4% for Older Adults After Major Surgery

The American College of Rheumatology guidelines recommend discontinuing anti-TNF agents 1 to 4 weeks before surgery. [7] Available evidence suggests that methotrexate can be continued throughout the perioperative period. [8]
The American College of Rheumatology guidelines recommend discontinuing anti-TNF agents 1 to 4 weeks before surgery. [7] Available evidence suggests that methotrexate can be continued throughout the perioperative period. [8]
One-year mortality following major surgery increased for adults aged 65 years or older with frailty or probable dementia

HealthDay News — For community-dwelling older adults, one-year mortality after surgery is 13.4 percent, with higher mortality for nonelective than elective procedures, according to a study published online Oct. 19 in JAMA Surgery.

Thomas M. Gill, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a prospective longitudinal cohort study with one-year follow-up involving 5,590 community-living fee-for-service Medicare beneficiaries aged 65 years or older to examine population-based estimates of mortality after major surgery. Data were included for 1,193 major surgeries performed from 2011 to 2017.

The researchers identified 206 deaths during the one-year follow-up period, representing 872,096 survey-weighted deaths and 13.4 percent mortality. The mortality rates were 7.4 and 22.3 percent for elective surgeries and nonelective surgeries, respectively. One-year mortality was 6.0 and 27.8 percent for those who were nonfrail and frail, respectively, and was 11.6 and 32.7 percent for those without dementia and for those with probable dementia, respectively. The age- and sex-adjusted hazard ratios for one-year mortality were 4.41 and 2.18 for frailty and probable dementia, respectively, with restricted mean survival time of 48.8 and 44.9 days, respectively.

“Our findings suggest substantial differences in one-year mortality after major surgery across distinct subgroups of older persons and highlight the potential prognostic value of geriatric conditions such as frailty and dementia,” the authors write.

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