The following is the summary of “Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States” published in the January 2023 issue of Surgery by Becher, et al.
The purpose of this research was to determine how demographic and geriatric factors influence the prevalence and risk of major surgery among the elderly during a 5-year period. Due to the aging of the US population, there is a growing concern for providing high-quality surgical care in an environment where patients are guaranteed a minimal risk of injury. However, there is a lack of reliable, generalizable statistics on the frequency of major surgery among the elderly. Therefore, researchers analyzed information from the National Health and Aging Trends Study, a prospective longitudinal study of Medicare fee-for-service recipients 65 and older living in the community from 2011 to 2016.
Data from the Centers for Medicare & Medicaid Services was linked to information about major surgeries. The National Health and Aging Trends Study combined and stratum variables with analytic sample weights to provide population-based incidence and cumulative risk estimates. The estimated rates of elective and nonelective procedures, respectively, were 5.2 and 3.7 for the national population. When adjusting for age, gender, and presence or absence of dementia, the adjusted incidence of major surgery peaked at 10.8 in people aged 75 to 79, climbed from 6.6 in the non-frail group to 10.3 in the frail group, and was similar across the two extremes.
Nearly 5 million different older people (aged 85+) had a cumulative risk of major surgery over 5 years of 13.8%. This included 12.1% of those aged 85–89, 9.1% of those aged 90+, 12.1% of those frail, and 12.4% of those with probable dementia. Major surgery is a typical occurrence in the lives of older people living in the community, especially among high-risk susceptible groupings.
