# Optimizing surgical decision-making for nursing home residents undergoing surgery for bladder and bowel dysfunction

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $394,089

## Abstract

PROJECT ABSTRACT:
There is a fundamental gap in our understanding of outcomes related to surgery for bladder and bowel
dysfunction, which are ubiquitous conditions among nursing home residents. Despite these procedures
being relatively “low risk”, they are not without risk, particularly in an already functionally and cognitively
limited cohort. Currently, the only available information on such outcomes are from studies conducted in
younger and healthier individuals and they lack important functional and cognitive outcomes that are
meaningful to older adults. Our overarching research objective is to improve care for nursing home
residents with bladder and bowel dysfunction by providing them and their healthcare providers with realistic
expectations about the risks and benefits of surgical treatment for these conditions. The objective for the
proposed study is to better understand the surgical and functional outcomes of these procedures in the
nursing home population and to provide patients and their providers with a prognostic tool to assist in the
surgical decision-making process. The central hypothesis is that there are substantial and significant
immediate and long-term complications resulting from these procedures, spanning from high rates of
surgical morbidity and mortality (compared to community-dwelling controls) and poor functional outcomes
measured by activities of daily living, cognition and specific bowel and bladder functional outcomes. This
hypothesis will be tested by leveraging Minimum Data Set (MDS) for Nursing Home Resident Assessment
and Medicare claims data (inpatient and outpatient) by the following three specific aims: 1) to compare
short-term (30-day mortality, surgical complications, length of stay, readmission) and long-term (1-year
mortality and intensity of care) surgical outcomes between nursing home residents and age-, sex- and
comorbidity-matched community-dwelling older adults undergoing elective surgery for bladder and bowel
dysfunction, 2) to determine longitudinal changes in functional status, cognition, and bladder and bowel
function among nursing home residents following elective surgery for bladder and bowel dysfunction, and
3) to develop and internally validate a prognostic tool for nursing home residents considering elective
surgery for bladder and bowel dysfunction to predict surgical morbidity, mortality and postoperative
function, cognition and bladder and bowel function. This study is innovative because it will measure and
apply longitudinal functional and cognitive outcomes data to a prognostic tool for surgical procedures
performed to improve function among an already functionally impaired population. The proposed research
is significant because there is no information about outcomes for these common conditions in this large and
vulnerable population. Development of a prognostic tool to aid in this decision-making process will serve to
minimize the risks of potentially unsuccessful, unnecessary and even ...

## Key facts

- **NIH application ID:** 10161675
- **Project number:** 5R01AG058616-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Anne M. Suskind
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $394,089
- **Award type:** 5
- **Project period:** 2018-06-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10161675

## Citation

> US National Institutes of Health, RePORTER application 10161675, Optimizing surgical decision-making for nursing home residents undergoing surgery for bladder and bowel dysfunction (5R01AG058616-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10161675. Licensed CC0.

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