How safe is surgery for older patients?
Updated: Nov 16, 2021
When it comes to surgery for older adults, there’s good news and bad news.
The good news is that “In modern surgery, it’s a rare event to die from surgery,” according to Dr. Emily Finlayson, director of the University of California San Francisco’s Center for Surgery in Older Adults.
The bad news is what might happen afterwards, particularly for patients older than 80.
As people age, so do their bodies’ heart, lungs, kidneys and other organ functions, making it harder to bounce back from the intense stress of a surgical procedure. Age also slows down the body’s overall healing processes – even for something as trivial as a scratch or scrape. So older patients are vulnerable to virtually every potential post-op complication, including not only infection, but also heart, lung or kidney problems.
“Replacing someone’s hip when they’re 85 is harder than when they’re 50,” explains Dr. Clifford Ko, director of research and optimal patient care at the American College of Surgeons. “You body takes longer to recover.”
That’s bad news.
But there’s also good news: In and of itself, age is not a risk factor in surgery, according to a British Medical Journal report. But other factors – frailty, smoking, depression, and mental impairment – are.
Historically, many surgeons have declined to operate on patients because of their age alone. But it’s functional age, not chronological age, that really matters. Older patients who can dress themselves, bathe themselves, shop for themselves, and so on, have lower risks of complications.
Fragility, cognition, mobility, depression, and home support are also factors doctors need to consider.
Sa are the patient’s priorities. What do patients want to get out of a surgical procedure, and what’s most important to them afterwards? Doctors have routinely assumed that patients are undergoing surgery to live longer, says Dr. Mark Katlic, Sinai Hospital of Baltimore’s chief of surgery. But that’s not always the case, if living longer means living more painfully or less independently. So doctors need to ask older patients what’s more important to them: Length of life or quality of life?
In other words, it’s important for them to look at older patients as people instead of just as procedures.
At Senior Insights, that’s our guiding principle. It’s why, before we recommend any care, we start with a thorough three-part assessment of the client’s physical, psychosocial and mental status. It includes not only interviews with the senior, but also with his or her family, to assess their needs too. It’s why we match a plan of coordinated services custom-tailored to each senior’s and each family’s specific needs. And it’s why we use this knowledge to advocate your specific needs and desires to physicians, surgeons and other care providers.
To learn what a difference this holistic approach can make, please call or contact us to arrange a comprehensive consultation.