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Mobility Assessment Tool Developed To Facilitate Predicting Postoperative Risk In Older Adults

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A quick, reliable and cost-effective mobility tool has been developed by researchers from the Wake Forest Baptist Medical Center to aid in identifying older adult patients who are at risk of adverse postoperative outcomes.

Studying 197 patients older than 69 years old, who underwent elective, non-cardiac surgery at Wake Forest Baptist over the course of 20 months, the researchers saw that preoperative scores recorded using the Mobility Assessment Tool: Short Format (MAT-sf) were able to predict early postoperative complications, longer stays in the hospital as well as discharges to nursing homes.

Leanne Groban, M.D., lead author of the study and anesthesiology professor at Wake Forest Baptist, explained that preoperative assessments are important to patients and everyone involved because they can indicate when complications are likelier to occur.

"[O]ur results indicate that self-reported mobility ... can complement existing assessment tools in determining which patients are at risk of adverse postoperative outcomes," she said.

There are 10 common physical activities featured in the MAT-sf as animated video clips, each of which are accompanied by questions to determine a patient's ability to carry out a particular task. In addition to the MAT-sf, however, those participating in the study underwent four other preoperative risk assessment tests as well.

After factoring in perimeters like sex, age, body mass index and scores on other tests, the researchers discovered that poor MAT-sf scores were associated with short-term postoperative complications, longer stays in the hospital and discharges to nursing homes.

According to the researchers, standard risk assessment tests may be too focused on a single body part, too comprehensive or too impractical, rendering them useless in the setting.

The next steps for them are to validate the results of their study in a larger, multi-center research and to assess whether or not preoperative balance and strength training can have a hand in limiting adverse postoperative outcomes in mobility-limited older adults.

Applying the results of the study is a step toward not only improving functionality for patients, but speeding up their return as well to independence.

Published in the journal Anesthesiology, the study received funding support from the Claude D. Pepper Older Americans Independence Centers, Wake Forest Baptist's Clinical and Translational Science Institute and the Anesthesia Patient Safety Foundation.

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