How to Tell If Someone Is Too Old for Surgery

In All Health Watch, Featured Article, General Health, Health Warning

It’s a common dilemma faced by older people…

They need surgery for an urgent health problem, but their doctor doesn’t know if they are strong enough to withstand the operation. 

It can be a difficult decision for both the patient and the doctor. A life hangs in the balance. 

Typically, the decision on whether to operate is made on the basis of physical health.

How strong is the patient? Can they walk? Would they be able to do the necessary rehab after the procedure? Do they have an underlying condition like diabetes, heart disease, or obesity?

New research shows that the condition of a patient’s brain may be more important than any of these factors when it comes to surviving surgery.[1] 

The study comes from the University of California, San Francisco. Researchers looked at the medical records of 1,341 patients age 66and older..

They found that cognitive health was a strong predictor of surgery survival. People were far more likely to die within a year of major surgery if they had dementia.

Certain types of physical impairment were also linked to higher risk of one-year mortality:

  • The inability to walk a few blocks.
  • Needing help dressing or bathing.
  • Requiring help to take medication or use the phone.

And the amount of risk increased with the number of impairments.

Dr. Victoria L. Tang was one of the study authors. She said the question is whether, after surgery, “patients have that kind of psychiatric resilience, are they dependent, and are they going to be able to engage in recovery?”

That’s what “makes the difference in whether someone makes it or not,” said Dr. Tang.[2]

3 Ways to Improve Surgery Survival

Here’s what you can doto minimize your risk:

  1. Guard against infections. In recent years, hospital infections have become rampant. Every year, 648,000 Americans develop infections during a hospital stay. About 75,000 die.[3]

    And hospitals are often their own worst enemy. By overusing antibiotics, they have encouraged the growth of “superbugs” and killed off patients’ own protective bacteria. These superbugs are immune to antibiotics. They include MRSA and C. diff, and certain strains of staph bacteria.

    Scrupulous handwashing, both by patients and hospital staff, is important. But there are other anti-infection strategies you may not know about… 

    Don’t shave before going in for surgery. Many people do this. They figure they might not be able to shave in the hospital.

    Shaving causes tiny micro-cuts that can be an entryway for a hospital-borne infection. Let your stubble grow for a few days before going to the hospital.

    And don’t let your surgeon shave the surgical site. (Most have discontinued this practice.) Experts have known for decades that shaving the incision area increases infection risk.[4]

    Get the tube out ASAP. Central IV lines and catheters are high-risk sites for infection. If you have one of these, every day you should ask staff whether you still need it. The sooner you get rid of it, the less chance of infection.

    It’s not always possible for patients to get out of bed to wash their hands. Keep a bottle of alcohol-based (non-triclosan) hand sanitizer at your bedside. Use it regularly after you touch any surfaces or another person.

    Have someone use bleach wipes to disinfect frequently touched surfaces in your room once a day. These include TV remotes, bed rails, and door knobs.

    Go home ASAP. You can’t get a hospital infection if you’re not in the hospital. As soon as you feel ready to go home, ask your doctor to be released.
  2. Beware of the “July Effect.” July is the month medical residents fresh out of med school typically start their new jobs. Some 30,000 freshly minted doctors stream into hospitals around the country. An important part of the learning process is making mistakes. Let them learn on somebody else.

    The University of California, San Francisco, did a comprehensive review of 39 studies on the July Effect. It showed that hospital death rates increase up to 12% during the month. What’s more, patients endured longer surgery times and hospital stays.[5] [6]

    Avoid scheduling surgery for July or August if at all possible.
  3. Ask for a “timeout” before anesthesia. Before you go to the hospital, tell your surgeon you will want a “timeout” during surgical prep. This is becoming a common practice, so he or she will know what you’re talking about.[7]

    Before the anesthesia is administered, tell the nurse or doctor you’re ready for your timeout and want to speak to the surgical team. After they are gathered, state your name, birthdate, and the procedure you are having.

    Anyone involved in the surgery must know exactly who you are. This can prevent being confused with another patient. It’s especially important if you have a common last name.

    Then, ask the surgeon doing the cutting to mark the incision site while you watch. This is not being paranoid.

    “It’s very reasonable to ask and participate in the marking of the site,” said Dr. Peter Angood. He’s chief safety officer of The Joint Commission, the accrediting agency for U.S. hospitals.[8]

    Whether you’re a senior or not, there’s always an element of risk in going under the knife. Taking the steps above will help you make a fast and full recovery.

Editor’s Note: If you go into the hospital, your number one goal should be getting out alive. Discover the three biggest risks of having surgery and how to make sure you don’t fall victim to them. Get The Surgery Survival Guide. It’s in Independent Healing, your number-one source for evidence-based natural health solutions. To subscribe, go HERE.

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[1]https://jamanetwork.com/journals/jamasurgery/article-abstract/2762522

[2]https://www.medpagetoday.com/geriatrics/generalgeriatrics/85368?xid=nl_mpt_SRNeurology_2020-03-13&eun=g1421475d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=NeuroUpdate_031320&utm_term=NL_Spec_Neurology_Update_Active

[3]http://www.consumerreports.org/cro/health/hospital-acquired-infections/index.htm

[4]http://www.telegraph.co.uk/news/health/10415993/Wash-but-dont-shave-before-surgery-patients-told.html

[5]http://www.aarp.org/health/doctors-hospitals/info-06-2010/why_you_should_avoid_the_hospital_in_july.html

[6]http://opinionator.blogs.nytimes.com/2012/07/14/dont-get-sick-in-july/?_r=1

[7]http://www.jointcommission.org/assets/1/18/wrong_site_brochure.pdf

[8]http://well.blogs.nytimes.com/2007/11/28/when-surgeons-cut-the-wrong-body-part