Retirement Living takes an unbiased approach to our reviews. We may earn money when you click a partner link. Learn More
High-risk emergency surgery can cost seniors a month of independent living, study finds
The importance of ‘healthy days at home’
Updated:
key insights:
- Older adults who undergo high-risk emergency surgery spend about one month less living independently at home in the year after surgery than those who have lower-risk emergency procedures, according to a new study.
- Researchers say “healthy days at home” is a better measure of recovery than survival alone because it reflects the time patients spend outside hospitals and nursing facilities.
- The findings could help patients, families, and surgeons make more informed decisions when emergency surgery is needed.
Older adults who undergo high-risk emergency surgery may survive their operation but lose something many value just as much: time spent living independently at home.
A new study published in the Journal of the American College of Surgeons found that seniors who underwent high-risk emergency general surgery spent about one month fewer at home during the year after their operation than patients who had lower-risk emergency procedures.
Researchers say the findings highlight the importance of looking beyond traditional measures such as survival rates and surgical complications when evaluating outcomes for older adults.
“Healthy days at home” — the number of days a patient is alive and living outside hospitals, rehabilitation centers, and skilled nursing facilities — has emerged as a patient-centered way to measure recovery. Many older adults rank maintaining independence among their highest priorities, making the metric especially meaningful.
1.1 million people in the study
The researchers analyzed Medicare claims from more than 1.1 million beneficiaries aged 65 and older who underwent emergency general surgery between 2016 and 2018.
Patients who required high-risk procedures, such as emergency surgery involving the stomach, intestines, or other major abdominal organs, averaged about 27 fewer healthy days at home during the year after surgery than those who underwent lower-risk emergency operations.
The study also found that other factors further reduced time spent at home after surgery, including:
- Advanced age
- Dementia
- Frailty
- Multiple chronic health conditions
- Living in a nursing home before surgery
A different way to measure recovery
Lead author Dr. Harleen K. Sandhu of the University of California, San Francisco, said survival alone doesn’t capture what matters most to many older patients.
Instead, measuring healthy days at home provides a clearer picture of how surgery affects quality of life and independence after discharge. Patients often want to know not only whether they’ll survive an emergency operation but also whether they’ll be able to return to their homes and resume normal daily life.
The researchers suggest the findings can help surgeons have more meaningful conversations with patients and their families when emergency surgery is necessary.
While emergency situations often leave little time for deliberation, understanding the likely recovery trajectory — including the possibility of spending extended time in hospitals or nursing facilities — may help patients and caregivers make treatment decisions that better align with their personal goals and preferences.
The authors say future research should focus on identifying interventions that could increase the number of healthy days at home following emergency surgery, particularly for frail older adults at highest risk of prolonged institutional care.