Which is the association between patient-related variables and type of hospital discharge in geriatric surgical patients? Findings from a retrospective study

Geriatric surgical patients often have clinical and social factors influencing their discharge destination. This retrospective study examines patient-related variables associated with home discharge in individuals aged ≥65 years who underwent general, orthopedic, otolaryngologic, urologic, or vascular surgery in three northern Italian hospitals (January-December 2024). Functional status was assessed using the Barthel Index, along with sociodemographic and clinical data. Among 2015 patients, 77% were discharged home. Positive predictors of home discharge included older age (OR=1.040, p < 0.001), higher Barthel Index at discharge (OR=1.028, p < 0.001), and higher hemoglobin levels (OR=1.023, p < 0.001). Negative predictors included male sex (OR=0.496, p < 0.001), higher Barthel Index at admission (OR=0.983, p < 0.001), orthopedic surgery (OR=0.118, p < 0.001), and higher BRASS scores (OR=0.842, p < 0.001). Functional independence significantly influences discharge destination in geriatric surgical patients. Integrating standardized preoperative functional assessments alongside clinical and sociodemographic variables may improve discharge planning.