Loss of independence (LOI) is defined as a decline in functional status, deterioration
in mobility, or new requirements for special services such as new home care or skilled
nursing facility needs.
1
Compared with younger individuals, more older adults value functional independence
over morbidity when rating factors important to their general well-being.
- Berian J.R.
- Mohanty S.
- Ko C.Y.
- Rosenthal R.A.
- Robinson T.N.
Association of loss of independence with readmission and death after discharge in
older patients after surgical procedures.
JAMA Surg. 2016; 151e161689https://doi.org/10.1001/jamasurg.2016.1689
2
Many older patients associate a lower quality of life with LOI. LOI is different
from loss of autonomy, which is defined as loss of the ability to make personal decisions
such as those pertaining to goals of care. Although morbidity and mortality do not
sufficiently reflect the values of the growing number of older individuals who undergo
surgical procedures, most of the current surgical literature focuses on those two
outcomes as measures of surgical quality rather than LOI. The frequency of LOI is
often underestimated.
1
However, a recent study using new geriatric-specific variables from the American
College of Surgeons National Quality Improvement Program Geriatric Surgery Pilot Project
showed that LOI occurred in 59.6% of surgical patients older than 65 years.
- Berian J.R.
- Mohanty S.
- Ko C.Y.
- Rosenthal R.A.
- Robinson T.N.
Association of loss of independence with readmission and death after discharge in
older patients after surgical procedures.
JAMA Surg. 2016; 151e161689https://doi.org/10.1001/jamasurg.2016.1689
1
- Berian J.R.
- Mohanty S.
- Ko C.Y.
- Rosenthal R.A.
- Robinson T.N.
Association of loss of independence with readmission and death after discharge in
older patients after surgical procedures.
JAMA Surg. 2016; 151e161689https://doi.org/10.1001/jamasurg.2016.1689
Abbreviations:
LOI (Loss of Independence), NSQIP (National Surgical Quality Improvement Program)To read this article in full you will need to make a payment
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References
- Association of loss of independence with readmission and death after discharge in older patients after surgical procedures.JAMA Surg. 2016; 151e161689https://doi.org/10.1001/jamasurg.2016.1689
- The influence of age on health valuations: the older olds prefer functional independence while the younger olds prefer less morbidity.Clin Interv Aging. 2014; 10: 1131-1139https://doi.org/10.2147/CIA.S78698
- Frailty predicts loss of independence after liver surgery.J Gastrointest Surg. 2022; 26: 2496-2502https://doi.org/10.1007/s11605-022-05513-8
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- Discharge planning from hospital to home.Cochrane Database Syst Rev. 2013; : CD000313https://doi.org/10.1002/14651858.CD000313.pub4
- Postoperative functional outcomes in older adults.Curr Surgery Rep. 2016; 4https://doi.org/10.1007/s40137-016-0140-7
- New 5-factor modified frailty index using American College of Surgeons NSQIP data.J Am Coll Surg. 2018; 226 (e8): 173-181https://doi.org/10.1016/j.jamcollsurg.2017.11.005
Article info
Publication history
Published online: February 03, 2023
Accepted:
February 2,
2023
Received in revised form:
January 17,
2023
Received:
January 7,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
