WEDNESDAY, May 12, 2021 — Older Americans, especially those 85 and older, are having fewer abdominal surgeries than in decades past, a new study finds.
The study examined data from 2002 to 2014, and was not able to tell the exact reasons for the trend. It might be that improvements in medical treatments and cancer screening for older adults are reducing the need for invasive surgeries, the researchers said.
“There was a really stark decrease in the number of surgeries among older adults over the age of 65 throughout the study period,” said researcher Dr. Daniel Rubin, an associate professor of anesthesia and critical care at University of Chicago Medicine. “This suggests we’re getting better at determining who would benefit most from a surgery, and also possibly that we’ve developed better and less invasive alternative treatments.”
Although the frequency of surgery in older adults is decreasing, there are some exceptions. Researchers found that some operations are done more often and some hospitals are doing more operations than others.
“The biggest surprise was that we saw a redistribution of surgical procedures to certain types of hospitals,” Rubin said in a university news release.
“There was a large shift away from rural and non-teaching urban hospitals to major academic medical centers; these were the only hospitals that saw an increase in the frequency of procedures performed on older adults,” he said. “We think this may be due to increased specialization and that some procedures that may not be available at a smaller or rural institution are more likely to be offered at a larger, academic hospital.”
A less surprising increase was for the Whipple procedure for treating pancreatic cancer. This procedure, also known as a pancreaticoduodenectomy, is a major operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct.
“With pancreatic cancer, there aren’t really many less invasive options available, and outcomes are generally good even for older adults,” Rubin said. “We perform Whipple procedures on 85- or 90-year-old adults here at UChicago Medicine simply because it is usually the most effective option.”
These findings are important because older adults often struggle to recover after major surgeries.
Researchers found that more than 50% of adults over 85 require at least some transitional medical care after surgery.
“Older adults really want to get back to their normal life after an operation,” said Rubin. “But recovery can be difficult, and the rates at which older adults require post-acute care — such as time in a rehabilitation facility or long-term care — is high. These results can help inform the decisions made by patients and providers on whether or not a surgery is the right choice for them.”
The report was published May 10 in the Journal of the American Geriatric Society.
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Posted: May 2021