In recent years, the focus of anesthetic outcome research has broadened beyond the classical 48-hour postoperative period. Major cardiovascular and neurologic morbidity extending from months to years postoperatively are currently being investigated. The studies of cognitive dysfunction in particular have used batteries of psychometric tests that have included rudimentary functional outcome measures. While representing a landmark in the development of anesthetic care for the elderly, it nonetheless did not focus on the impact of the surgical procedure on patient independence, disability and the ultimate quality of functional recovery. Outcome literature from internal medicine and the surgical specialties has considered a wider view and has taken broader approaches.
Anesthetic data are rudimentary.
Both preoperative functional status and cognitive status are measured by relatively insensitive tri-level classification systems. The authors accurately predicted that hip arthroplasty patients would manifest improved physical domain scores. This study confirmed the need for multidimensional measures to fully capture changes in health-related quality of life after surgery as used in the Postoperative Functional Outcomes in Elders study. Evaluations of health-related quality of life distinguished differences between various types of surgeries. Focusing on abdominal surgeries, the first major evaluation of functional outcomes for elder patients is currently in progress under the direction of Valerie Lawrence, M.D., at the University of Texas Health Science Center, San Antonio, Texas.