Loss of independence is defined as a decline in function or mobility, increased care needs at home or discharge to a nonhome destination. A study recently published in JAMA Surgery found this metric is strongly associated with readmission and death after discharge for older surgical patients.
Researchers examined a group of 5,077 patients ages 65 and older who underwent surgery at 26 hospitals from January 2014 to December 2014. They found that loss of independence increased with age and was the second most important factor (behind serious postoperative complication) related to readmission, increasing risk by 70 percent.
LOI was associated with a 6.7-fold increased risk of death after discharge as well.
"Patient-centered outcomes such as LOI can, and should, be collected in multi-institutional data registries," the authors concluded. "Loss of independence is a potential target for intervention, and future work should move beyond its use as a factor for prognostication. To best serve the aging population, clinical initiatives must focus on efforts to minimize LOI and better understand its association with discrete outcomes like readmission and death after discharge."