Karen L Miller1, Holly E Richter2, Charles S Graybill3, Leigh A Neumayer4. 1. University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: karen.miller@hsc.utah.edu. 2. University of Alabama at Birmingham, Department of Obstetrics and Gynecology, 1700 6th Av South, Suite 10382, Birmingham, AL 35233, USA. Electronic address: hrichter@uabmc.edu. 3. University of Utah, Department of Orthopaedics, University Orthopaedic Center, 590 Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: chuck.graybill@hsc.utah.edu. 4. University of Utah, Department of Surgery, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: lneumayer@surgery.arizona.edu.
Abstract
PURPOSE OF STUDY: To examine change in balance-related fall risk and daily functional abilities in the first 2 post-operative weeks and up to 6 weeks after gynecologic surgery. MATERIALS AND METHODS: Prospective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre- and post-operatively daily for 1 week and twice the second week. Physical performance balance and functional mobility were measured pre- and 1 week post-operatively using the Tinetti Fall Risk Scale, Timed Up and Go, and 6-Minute Walk test. Measures were repeated 6 weeks after surgery. Non-parametric tests for paired data were used comparing scores baseline to post-operative (POD) 7 and to POD 42. RESULTS: Median age was 72 years (range 65-88). Fall risk was elevated during the first 2 post-operative weeks, greatest on the median discharge day, POD 2 (p<0.01). Balance performance and functional mobility at 1 week were significantly lower than baseline (p<0.01). Functional abilities declined, including new dependence in medication management at home in 22% of these independent and cognitively intact women. CONCLUSIONS: After gynecologic surgery, older women's fall risk is highest on POD 2 and remains elevated from baseline for 2 weeks. Functional limitations in the early home recovery period include the anticipated (bathing, cooking, etc.) and some unanticipated (medication management) ones. This information may help with post-operative discharge planning.
PURPOSE OF STUDY: To examine change in balance-related fall risk and daily functional abilities in the first 2 post-operative weeks and up to 6 weeks after gynecologic surgery. MATERIALS AND METHODS: Prospective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre- and post-operatively daily for 1 week and twice the second week. Physical performance balance and functional mobility were measured pre- and 1 week post-operatively using the Tinetti Fall Risk Scale, Timed Up and Go, and 6-Minute Walk test. Measures were repeated 6 weeks after surgery. Non-parametric tests for paired data were used comparing scores baseline to post-operative (POD) 7 and to POD 42. RESULTS: Median age was 72 years (range 65-88). Fall risk was elevated during the first 2 post-operative weeks, greatest on the median discharge day, POD 2 (p<0.01). Balance performance and functional mobility at 1 week were significantly lower than baseline (p<0.01). Functional abilities declined, including new dependence in medication management at home in 22% of these independent and cognitively intact women. CONCLUSIONS: After gynecologic surgery, older women's fall risk is highest on POD 2 and remains elevated from baseline for 2 weeks. Functional limitations in the early home recovery period include the anticipated (bathing, cooking, etc.) and some unanticipated (medication management) ones. This information may help with post-operative discharge planning.
Authors: Bradley A Fritz; Christopher R King; Divya Mehta; Emily Somerville; Alex Kronzer; Arbi Ben Abdallah; Troy Wildes; Michael S Avidan; Eric J Lenze; Susan Stark Journal: JAMA Netw Open Date: 2022-03-01