INTRODUCTION: Both cognitive impairment/dementia (CID) and falls occur more commonly in older adults compared to younger patients. This study aims to analyze the association of a history of CID or falls with the postoperative outcomes of older adults undergoing major intraabdominal surgeries on a national level.
METHODS: We retrospectively analyzed the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) 2022 Participant Use Data File. Our primary outcome was postoperative mortality. Statistical analysis was performed using Chi-square test, and multivariate regression analysis.
RESULTS: On multivariable regression analyses, both a history of CID (OR: 1.9; CI: 1.5-2.5; p <0.01) and a fall (OR: 1.8, CI: 1.4 -2.3; p <0.01) were independently associated with higher adjusted odds of mortality. History of CID or falls was also a predictor of overall complications, major complications, and discharge to a care facility.
CONCLUSION: A history of CID or falls in older adults prior to major intraabdominal surgeries is associated with a high risk of postoperative mortality and morbidity. Further studies are required to establish the causal relation of these factors and the steps to mitigate the risk of associated adverse outcomes.