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.
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.
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.
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.
Archives of gerontology and geriatrics. 2017 Jul 19 [Epub ahead of print]
Karen L Miller, Holly E Richter, Charles S Graybill, Leigh A Neumayer
University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: ., University of Alabama at Birmingham, Department of Obstetrics and Gynecology, 1700 6th Av South, Suite 10382, Birmingham, AL 35233, USA. Electronic address: ., University of Utah, Department of Orthopaedics, University Orthopaedic Center, 590 Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: ., University of Utah, Department of Surgery, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: .