More than a quarter of nursing home patients died, compared to just 10% of people with other living arrangements.
More than a quarter of nursing home patients died in the hospital after emergency abdominal surgery — the kind that would treat a gall bladder infection or appendicitis — compared to just 10% of people who had that procedure but did not live in the same environment, a new study found.
Part of the problem is frailty, said Anne Mosenthal, senior author of the study and a professor and chair of the Rutgers New Jersey Medical School. Nursing home residents are typically more frail than those who do not live in a community dwelling, which increases the risk of emergency procedures. Many nursing home residents can become frail because they are bedridden or because they suffer dementia.
Emergency abdominal surgery may be warranted because of a blockage in the intestines, an infection in the gall bladder or appendicitis, but frailty can increase the risk of numerous types of other surgeries as well, Mosenthal said. “There should be conversations with patients or their families about the reality before surgery, so that people can make a decision about undergoing risky procedures,” Mosenthal said. Some patients or family members may want to opt for palliative care, which monitors the comfort level of patients with serious, life-threatening illnesses, but they should also discuss these options before the possibility of an emergency procedure.
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