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Explanation:
ames Brantner had always been scrupulous about maintaining his health. He sees his primary care doctor annually, avoids sweets and developed a habit of walking 3.5 miles every other day near his home just outside Harrisburg, Pennsylvania.
So when a routine colonoscopy in 2017 showed evidence of cancer, Brantner, then 76, was stunned. He’d need 12 radiation treatments, followed by surgery to reconstruct his colon. His physician recommended Johns Hopkins Hospital’s colorectal surgeon Susan Gearhart.
“The surgery [which took place last December] was quite extensive,” says Brantner, a retired planning officer for the Pennsylvania Department of Transportation. “Dr. Gearhart was very upfront with me—and compassionate.” He recalls little about his two days in the intensive care unit, but all went well during the surgery and hospital stay. And, though he’s lost 30 pounds and is not yet able to walk long distances, Brantner says he’s getting his appetite back and feels stronger every day.
More than a third of all surgeries in U.S. hospitals—inpatient and outpatient procedures combined—are now performed on people age 65 and over, according to the Centers for Disease Control and Prevention. That number, 38 percent, is expected to increase: By 2030, studies predict there will be some 84 million adults in this age group, many of whom will likely need surgery.
Last year, across all five adult Johns Hopkins medical centers, 36 percent of surgeries—48,359—took place in the 65-plus population.
Now, Johns Hopkins Bayview—a longtime hub for comprehensive health care of older adults—is poised to become a “center of excellence” in geriatric surgery. This means the American College of Surgeons will likely recognize Hopkins Bayview as offering a high concentration of expertise and resources devoted to caring for older-adult patients in need of surgery, leading to the best possible outcomes. Hopkins Bayview is one of eight hospitals expecting to merit this distinction, which also recognizes extensive research. (The others, which include community hospitals, veterans’ hospitals and academic centers, are Denver Veterans Affairs Medical Center, Kaiser Permanente Fresno, New York University Winthrop Hospital, University of Alabama, University of Connecticut, University of Rochester, and University Hospital—Rutgers’s—in Newark, New Jersey.)
Gearhart is among the leaders championing the program. Others include Perry Colvin, medical director for Peri-Operative Medicine Services; and Thomas Magnuson, Hopkins Bayview’s chairman of surgery, as well as geriatric nurse practitioners JoAnn Coleman, Jane Marks and Virginia Inez Wendel.
Shifting Perceptions of Aging
While advances in technology and medicine make it easier for people to live longer, healthier lives, no one is sure how factors such as chronological age and chronic disease affect geriatric surgical outcomes.
Consider Podge Reed. In 2011, he was 70 years old, trim and still working as chairman of the board of an oil production company. He played golf regularly and was an avid gardener. Then, during an annual physical, he learned that his lungs were impaired. He’d acknowledged having some recent shortness-of-breath episodes and was diagnosed with lung disease of unknown origin. Within a few months, Reed was placed on a transplant waiting list for a new set of lungs.
Four days after being placed on the transplant waiting list, Reed received a call from the hospital: A 41-year-old organ donor had just died, and the victim’s lungs appeared to be suitable for Reed in blood type and body size. The transplant went well, and Reed remained in the hospital for 56 days—longer than usual for most lung transplant patients because of a lung infection.
