title: Home Return After Surgery in Patients Aged over 85 Years is Associated with Preoperative Albumin Levels, the Type of Surgery, and APACHE II Score.
abstract: Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home return (HR), because quality of life is valuable to these patients. We identified predictors for HR of patients aged >85 years admitted to the ICU after surgery.
  
  
  
  Retrospective analysis of medical records was conducted at a university hospital. Patients aged > 85 years, admitted to the ICU after surgery from March 2006 to June 2015 (n = 187), were divided into a HR group (patients who returned home after discharge) and non-HR group (deceased or transferred to nursing facilities). Perioperative data and outcome were assessed and compared. Multivariate logistic regression analysis was conducted to identify independent predictors.
  
  
  
  The average age of patients was 88 years. HR occurred in 61% of patients, and mortality was 9%. The HR group had higher preoperative albumin level than did the non-HR group. More patients in the non-HR group experienced hip surgery than in the HR group (51 vs. 12%, P < 0.001). APACHE II score was higher (P < 0.001) in the non-HR group. In multivariate analysis, preoperative albumin, hip surgery, and APACHE II score were independent predictors of HR.
  
  
  
  Predictors of HR of surgical critically ill elderly patients included preoperative albumin level, hip surgery, and APACHE II score on ICU admission.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
authors.forename: Bora
authors.initials: B
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
authors.forename: Sungwon
authors.initials: S
authors.lastname: Na
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
authors.forename: Miran
authors.initials: M
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
authors.forename: Sungyeon
authors.initials: S
authors.lastname: Ham
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. anesjeongmin@yuhs.ac.
authors.forename: Jeongmin
authors.initials: J
authors.lastname: Kim
mesh_terms: D018806:APACHE; D000369:Aged, 80 and over; D005260:Female; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D012709:Serum Albumin; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data
chemical_list: D012709:Serum Albumin