Using Latent Class Analysis to Identify Subgroups of Post-Operative Older Adults

ObjectiveIdentify subgroups of postoperative older adults using electronic health record data. Summary of Background DataPostoperative older adults represent a vulnerable population who may benefit from tailored postoperative care pathways. Identifying clinical subgroups can inform the development of these pathways. MethodsRetrospective cohort study of postoperative adults >65 years (N=2,036) from a single healthcare system. Latent class analysis was used to identify patient subgroups based on measures of frailty, mobility, activities of daily living, and general health status. Hospital outcomes were described among each subgroup, including extended lengths of stay (LOS) (>0.5 SD beyond mean LOS by surgical category), discharge disposition (i.e., home versus non-home discharge), and utilization (weekly visit frequency) of physical therapy (PT) and occupational therapy (OT). ResultsWe identified 3 subgroups that we labeled Low Frailty-High Mobility (LF-HM), High Frailty-Low Mobility (HF-LM), and Low Frailty-Low Mobility (LF-LM), representing 15.3%, 27.6%, and 57.1% of the cohort, respectively. Discharge to home was highest among the LF-HM group (99%), followed by LF-LM (96%), and HF-LM (77%). Extended LOS was most common among the HF-LM group (27%), followed by LF-LM (18%), and LF-HM (6%). PT and OT visit frequencies were highest in the HF-LM group followed by the LF-LM and LF-HM groups. ConclusionsThis study identified 3 subgroups of postoperative older adults using routinely collected patient data. These groups may help to identify patients with increased odds of non-home discharge, extended LOS, and higher utilization of PT and OT and may inform the development of tailored postoperative care pathways for older adults.