Abstract
Purpose :
For frail patients, even low-risk procedures increase postoperative mortality risk. In a study population comprising older adults who underwent cataract surgery, we examined associations between frailty and non-vision-related health outcomes after cataract surgery, the most common procedure among Medicare beneficiaries.
Methods :
We used National Health and Aging Trends Study (2010-2014) data linked to Centers for Medicare and Medicaid Services claims. Frailty (criteria: exhaustion, low physical activity, weakness, slowness, shrinking), the predictor variable, was assessed at the visit prior to cataract surgery, and participants were classified as frail (≥3 criteria), prefrail (1-2 criteria) or robust (0 criteria). Multivariable models, adjusted for age, gender, race, smoking, diabetes, and number of comorbidities, were used to examine associations between frailty and hospitalization rate, emergency department (ED) visits, and hospital length of stay (LOS) over the 12-months after cataract surgery.
Results :
A total of 557 participants who underwent cataract surgery during the study period (2011-2014) were included in the analysis. Participants were a mean age of 76 (SE=0.3) years, and the majority were female (58%) and white (77%), and 11% were classified as frail, 49% prefrail, and 40% robust, prior to cataract surgery. In regression analysis, the odds of hospitalization in the year following cataract surgery were greater among pre-frail (OR=1.8; 95% CI=1.0, 3.2) and frail older adults (OR=3.8; 95% CI=1.8, 8.1), as compared to robust older adults. Prefrail (OR=1.5; 95% CI=0.9, 2.4) and frail (OR=2.8; 95% CI=1.5, 5.5) older adults also had greater odds of an ED visit, as compared to robust older adults. In addition, prefrail (IRR=2.4; 95% CI: 1.1, 4.8) and frail (IRR=3.8; 95% CI=1.3, 11.1) older adults had greater LOS when hospitalized, as compared to robust older adults.
Conclusions :
Prefrail and frail older adults undergoing cataract surgery were more likely to be hospitalized and have an ED visit, as well as have longer LOS in the following year, suggesting that frailty may be a risk factor for these negative outcomes following cataract surgery.
This is a 2021 ARVO Annual Meeting abstract.