High-risk emergency surgeries significantly reduce healthy days at home for older adults.

• Patients undergoing high-risk procedures had an average of 307.88 healthy days at home, compared to 345.30 days for low-risk procedures (p<0.001).
• One-year mortality was notably higher for high-risk surgeries at 18.1% versus 5.21% for low-risk cases (p<0.001).

Decision-making should consider patient factors like age, dementia, and frailty, which are linked to lower home recovery days.

• Dementia patients experienced nearly 50 fewer healthy days at home, emphasizing the need for tailored counseling.