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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