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Table 4 Prospective studies of risk factors associated with non-home discharge among older adults undergoing elective surgery

From: Identifying older adults at risk of harm following elective surgery: a systematic review and meta-analysis

Study

Number of patients

Non-home discharge

Discharge destination

Factors associated with non-home discharge

Factors not associated with non-home discharge

N

%

Badgwell, 2013 [2]

111

11

10

Skilled nursing facility (including inpatient rehabilitation facilities)

Weight loss ≥ 10% (OR 6.52, 95% CI 1.43–29.76), ASA score ≥ 2 (OR 5.08, 95% CI 1.13–22.78), ECOG performance status ≥ 2 (OR 4.51, 95% CI 1.03–19.71)

Polypharmacy (OR 1.33, 95% CI 0.38–4.64), distant stage cancer (OR 0.54, 95% CI 0.11–2.64)

Blakoe, 2015 [61]

79

NR

NR

Another hospital

Frailty (OR 6, P = 0.002)

NR

Courtney-Brooks, 2012 [38]

37

1

2.7

Skilled nursing facility

NR

Frailty (P = 0.25)

Dasgupta, 2009 [7]

125

NR

NR

Institution

Age (P = 0.0009), Edmonton Frailty Scale score (P = 0.013)

NR

Kim, 2013 [51]

141

26

19.3

Nursing home, transitional care facility, or acute care facility

NR

Cumulative number of impairments on CGA (OR 1.216, 95% CI 0.864–1.712, for death or post-discharge institutionalization)

Kim, 2014 [40]

275

24

8.7

Nursing home, transitional care, or any long-term care facility

Frailty (OR 1.42, 95% CI 1.09–1.86)

NR

Kim, 2016 [37]

197

27

13.7

Nursing home

Mobility assessment tool – short form (OR 2.01, 95% CI 1.13–3.56), intermediately frail/frail (OR 3.11, 95% CI 1.02–9.54), age (OR 1.15, 95% CI 1.05–1.27), preoperative pain score (OR 0.83, 95% CI 0.70–0.99)

NR

Kothari, 2011 [45]

60

6

10

Location other than home

IADL score for ‘shopping’ (P = 0.003)

IADL scores (food preparation, housekeeping, laundry, medications, managing money, telephone usage, transportation), NSI Nutritional Health Checklist, GDS

Legner, 2004 [66]

586

43

14

Nursing home

Age 70–74 years vs. < 65 years (OR 5.4, 95% CI 1.9–15.7), 75–79 years (OR 10.5, 95% CI 3.7–29.5), ≥ 80 years (OR 16.3, 95% CI 5.5–48.7)

Age 65–69 years vs. < 65 years (OR 2.5, 95% CI 0.8–8.3)

Makary, 2010 [29]

594

NR

NR

Skilled or assisted-living facility

Frailty (OR 20.48, 95% CI 5.54–75.68)

NR

Min, 2015 [65]

49

NR

NR

All non-home locations

NR

Any of the baseline geriatric assessments

Robinson, 2012 [25]

186

52

29

Institutional care facility (i.e., nursing home, skilled nursing facility or rehabilitation centre)

Impaired cognition (OR 3.01, 95% CI 1.55–5.86)

NR

Williams, 2013 [53]

148

47

31.8

Healthcare facility

NR

Anxiety vs. none (OR 2.29, 95% CI 0.65–8.10)

  1. ASA American Society of Anesthesiologists, CGA comprehensive geriatric assessment, ECOG Eastern Cooperative Oncology Group, GDS geriatric depression scale, IADL instrumental activities of daily living, NSI Nutrition Screening Initiative, CI confidence interval, NR not reported, OR odds ratio