It has long been known that the elderly have an increased risk of complications following surgery, due to frailty and the likelihood of advanced medical problems. But a particular subset of this group -- nursing home residents -- have an even higher risk of dying following surgery than other people their age, a new study has found.
"We may be too aggressive with surgery in nursing home residents," said lead researcher Dr. Emily Finlayson, who specializes in gastrointestinal surgery at the University of California.
The study examined death rates after abdominal surgeries among some 70,000 nursing home residents and 1 million elderly (65 and older) not institutionalized. Death rates were consistently higher among the nursing home residents, even after taking age, sex and other illnesses into account.
For example, 12 percent of nursing home residents died within a month of having their appendix removed, in what is considered a low-risk surgery, compared to just 2 percent of the noninstitutionalized elderly. Likewise, 32 percent versus 13 percent died after colon removal surgery, and 42 percent versus 26 percent died after surgery for bleeding ulcers.
The study was published in the Annals of Surgery journal.
These findings should be shared with nursing home residents and their families when deciding whether to perform a particular surgery, fellow researcher Dr. Nader Massarweh said. "I think having an informed discussion is the best course of action."
Some 1.4 million people live in nursing homes, according to the Centers for Disease Control and Prevention.