Skip to main content

Surgery in the Frail Elderly: Nursing Home Patients

  • Chapter
Principles and Practice of Geriatric Surgery
  • 313 Accesses

Abstract

As our population ages, survivors will approach the limit of aging, or the life-span. As a result of primary and preventive medicine, heathier life styles, and decreased health risk, the population of the United States and other Western societies is trending toward this limit. A comparative study performed on life expectancy of 80-year-old persons in Western countries showed that American octogenarian men and women are expected to live 7.0 and 9.1 more years, respectively. In England the survival of octogenarians was 6.2 and 8.1 years, respectively; in France 6.7 and 8.6 years, respectively; in Sweden 6.5 and 8.3 years, respectively; and in Japan, 6.5 and 8.9 years, respectively.1

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Manton DG, Vaupel JW. Survival after the age of 80 in the United States, Sweden, France, England and Japan. N Engl J Med 1995;333:1232–1235.

    Article  PubMed  CAS  Google Scholar 

  2. Katz S, Branch LG, Branson MH, Papsidero JA, Beck JC, Greer DS. Active life expectancy. N Engl J Med 1983;309: 1218.

    Article  PubMed  CAS  Google Scholar 

  3. Roush W. Live long and prosper? Science 1996;273:42–46.

    PubMed  CAS  Google Scholar 

  4. Fries JF. Aging, natural death and the compression of morbidity. N Engl J Med 1980;303:130–135.

    Article  PubMed  CAS  Google Scholar 

  5. Duffy ME, Macdonald E. Determinants of functional health of older persons. Gerontologist 1990;30:503–509.

    Article  PubMed  CAS  Google Scholar 

  6. Vita AJ, Terry RB, Hubert HB, Fries JF. Aging, health risks and cumulative disability. N Engl J Med 1998;338:1035–1041.

    Article  PubMed  CAS  Google Scholar 

  7. Campion EW. Aging better. N Engl J Med 1998;338: 1064–1066.

    Article  PubMed  CAS  Google Scholar 

  8. Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994;330:1769–1775.

    Article  PubMed  CAS  Google Scholar 

  9. Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ, Wood JL. The effect of age on the association between body mass index and mortality. N Engl J Med 1998;338:1–7.

    Article  PubMed  CAS  Google Scholar 

  10. Kemper P, Murtaugh CM. Lifetime use of nursing home care. N Engl J Med 1991;324:595–600.

    Article  PubMed  CAS  Google Scholar 

  11. Appelgate WB, Miller ST, Graney MJ, Elam JT, Burns R, Akins DE. A randomized controlled trial of a geriatric assessment unit in a community rehabilitation hospital. N Engl J Med 1990;322:1572–1578.

    Article  Google Scholar 

  12. Gracey DR, Viggiano RW, Naessens JM, Hubmayr RD, Silverstein MD, Koenig GE. Outcomes of patients admitted to a chronic ventilator-dependent unit in an acute care hospital. Mayo din Proc 1992;67:131–136.

    Article  CAS  Google Scholar 

  13. Landefeld CS, Palmer RM, Kresevic DM, Fortinsky RH, Kowal J. Arandomized trial of care in a hospital medical unit especially designated to improve the functional outcomes of acutely ill older patients. N Engl J Med 1995;332:1338–1344.

    Article  PubMed  CAS  Google Scholar 

  14. Reuben DB, Borok GM, Wolde-Tsadik G, et al. A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. N Engl J Med 1995;332:1345–1350.

    Article  PubMed  CAS  Google Scholar 

  15. Ferrell BA, Osterweil D, Christenson P. A randomized trial of low-air-loss beds for treatment of pressure ulcers. JAMA 1993;269:269–494.

    Article  Google Scholar 

  16. Inman KJ, Sibbald WJ, Rutledge FS, Clark BJ. Clinical utility and cost effectiveness of an air suspension bed in the prevention of pressure ulcers. JAMA 1993;269:1139–1143.

    Article  PubMed  CAS  Google Scholar 

  17. Granick MS, McGowan E, Long CD. Outcome assessment of an in-hospital cross-functional wound care team. Plast Reconstr Surg 1998;101:1243.

    PubMed  CAS  Google Scholar 

  18. Zenilman ME, Bender JS, Magnuson TH, Smith GS. General surgical disease in the nursing home patient: results of a dedicated geriatric surgery consult service. J Am Coll Surg 1996;183:361–370.

    PubMed  CAS  Google Scholar 

  19. Rubenstein LZ, Wieland D, English P, Josephson K, Sayre JA, Abrass IB. The Sepulveda VA geriatric evaluation unit: data on four year outcomes and predictors of improved patient outcomes. J Am Geriatri Soc 1984;32:503–512.

    CAS  Google Scholar 

  20. Keller BK, Potter JF. Predictors of mortality in outpatient geriatric evaluation and management clinic patients. J Gerontol A Biol Sci Med Sci 1994;49:M246-M251.

    CAS  Google Scholar 

  21. Winograd CH, Gerety MB, Chung M, Goldstein MK, Dominquez F Jr, Vallone R. Screening for frailty: criteria and predictors of outcomes. J Am Geriatr Soc 1991;39: 778–784.

    PubMed  CAS  Google Scholar 

  22. Van Dijk PTM, van de Sande HJ, Dippel DWJ, Habbema JDF. The nature of excess mortality in nursing home patients with dementia. J Gerontol A Biol Sci Med Sci 1992;47: M28-M34.

    Google Scholar 

  23. Perls TT, Morris JN, Ooi WL, Lipsitz LA. The relationship between age, gender and cognitive performance in the very old: the effect of selective survival. J Am Geriatr Soc 1993;41:1193–1201.

    PubMed  CAS  Google Scholar 

  24. Brodaty H, McGilchrist C, Harris L, Peters KE. Time until institutionalization and death in patients with dementia: role of caregiver training and risk factors. Arch Neurol 1993;50:643–650.

    Article  PubMed  CAS  Google Scholar 

  25. Folstein MF, Folstein SE, McHugh PR. The Mini Mental State: a practical method for grading the cognitive skills of patients for the clinician. J Psychiatr Res 1975;12:189–198.

    Article  PubMed  CAS  Google Scholar 

  26. Skoog I, Nilsson L, Palmertz B, Andreasson LA, Svanborg A. A population-based study of dementia in 85 year olds. N Eng J Med 1993;328:153–158.

    Article  CAS  Google Scholar 

  27. Levine J, Michalski SA, Patel K, Kalemian M, Nelson M, Zenilman ME. Survival of patients in nursing homes referred for surgery. Surg Forum (in press).

    Google Scholar 

  28. Christakis NA, Escarce JJ. Survival of Medicare patients after enrollment in hospice programs. N Engl J Med 1996;335:172–178.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Zenilman, M.E. (2001). Surgery in the Frail Elderly: Nursing Home Patients. In: Rosenthal, R.A., Zenilman, M.E., Katlic, M.R. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3432-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-3432-4_16

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-3434-8

  • Online ISBN: 978-1-4757-3432-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics