CHICAGO — Surgical outcomes for older adults improve with a program that focuses on the specific needs of these patients, according to a study published in the Journal of the American College of Surgeons (JACS).
Geriatric surgical pathways (GSPs), which tailor care to the unique needs of older adults, aim to achieve better outcomes for patients. The researchers compared outcomes between two hospitals in the same academic health system — one with a GSP and one without.
“Our findings show that a dedicated geriatric surgical pathway makes a tangible difference for older patients,” said Sarah M. Jabour, MD, senior author of the study and research resident at Johns Hopkins in Baltimore, Maryland. “While it requires commitment to build these systems, we see patients spending less time in the hospital and facing fewer preventable hospital reported complications.”
Study Results
Researchers examined 3,098 older adults undergoing elective noncardiac surgery, with 24% at the hospital with a GSP and 76% at the hospital without a GSP. Key findings included:
- 50% Lower Risk of Complications: The rate of hospital reported complications (e.g., respiratory failure, sepsis, shock) per 1,000 discharges was over 50% lower at the hospital with the geriatric pathway.
- Shorter Hospital Stay: Patients at the GSP hospital had a significantly decreased risk of a longer length of stay, averaging about one fewer day than those at the non-GSP hospital.
There were slightly higher rates of 30-day readmission at the GSP hospital. The authors note this may reflect closer post-discharge follow-up, greater use of telehealth, or readmissions for medical reasons not directly related to the surgery.
“The hospital with the geriatric surgical pathway had a reduction in reportable complications,” Dr. Jabour said. “This isn’t just about better numbers — it represents fewer patients experiencing setbacks like pneumonia, which can drastically impact recovery.”
A System-Wide Approach to Aging
The study highlights the potential of system-wide programs to improve surgical care for a rapidly aging population. While geriatric surgical pathways and verification programs require initial investments in leadership and interdisciplinary teams, the data suggests significant clinical and operational benefits.
These findings align with the principles of the American College of Surgeons’ (ACS) Geriatric Surgery Verification (GSV) Program, a quality initiative that helps hospitals establish consistent, evidence-based pathways of care for older adults. The GSV Program has been shown in previous studies to lead to improved patient outcomes and long-term cost savings.
“What we’re seeing is that once these pathways are established, the benefits for patients are clear,” Dr. Jabour said. “As our population ages, having these systems in place isn’t just beneficial, it’s going to be essential to deliver safe, effective, and personalized surgical care to older adults.”
Co-authors are Oluwafemi P. Owodunni, MD, MPH; Solimar Santiago Del Rosario, BS; Dianne Bettick, RN; Fareeha Khan, MD; Thomas Magnuson, MD, FACS; and Susan L. Gearhart, MD, MEHP, FACS.
This study is published as an article in press on the JACS website.
Citation: Jabour S, Owodunni O, Del Rosario S, Bettick D, et al. A Tale Of Two Hospitals: Receiving Surgical Care at a Hospital with a Geriatric Surgical Pathway Improves Post-operative Outcomes. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000001797
