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Cooper Z, Mitchell SL, Gorges RJ, et al. Predictors of Mortality Up to 1 Year After Emergency Major Abdominal Surgery in Older Adults. J Am Geriatr Soc. 2015;63(12):2572-2579doi: 10.1111/jgs.13785.
Cooper, Z., Mitchell, S. L., Gorges, R. J., Rosenthal, R. A., Lipsitz, S. R., & Kelley, A. S. (2015). Predictors of Mortality Up to 1 Year After Emergency Major Abdominal Surgery in Older Adults. Journal of the American Geriatrics Society, 63(12), 2572-2579. https://doi.org/10.1111/jgs.13785
Cooper, Zara, et al. "Predictors of Mortality Up to 1 Year After Emergency Major Abdominal Surgery in Older Adults." Journal of the American Geriatrics Society vol. 63,12 (2015): 2572-2579. doi: https://doi.org/10.1111/jgs.13785
Cooper Z, Mitchell SL, Gorges RJ, Rosenthal RA, Lipsitz SR, Kelley AS. Predictors of Mortality Up to 1 Year After Emergency Major Abdominal Surgery in Older Adults. J Am Geriatr Soc. 2015 Dec;63(12):2572-2579. doi: 10.1111/jgs.13785. Epub 2015 Dec 11. PMID: 26661929; PMCID: PMC4688175.
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J Am Geriatr Soc. 2015 Dec;63(12):2572-2579. doi: 10.1111/jgs.13785. Epub 2015 Dec 11.

Predictors of Mortality Up to 1 Year After Emergency Major Abdominal Surgery in Older Adults.

Journal of the American Geriatrics Society

Zara Cooper, Susan L Mitchell, Rebecca J Gorges, Ronnie A Rosenthal, Stuart R Lipsitz, Amy S Kelley

Affiliations

  1. Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
  2. Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
  3. Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts.
  4. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
  5. Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  6. Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut.
  7. James J. Peters Veterans Affairs Medical Center, Bronx, New York.

PMID: 26661929 PMCID: PMC4688175 DOI: 10.1111/jgs.13785

Abstract

OBJECTIVES: To identify factors associated with mortality in older adults 30, 180, and 365 days after emergency major abdominal surgery.

DESIGN: A retrospective study linked to Medicare claims from 2000 to 2010.

SETTING: Health and Retirement Study (HRS).

PARTICIPANTS: Medicare beneficiaries aged 65.5 enrolled in the HRS from 2000 to 2010 with at least one urgent or emergency major abdominal surgery and a core interview from the HRS within 3 years before surgery.

MEASUREMENTS: Survival analysis was used to describe all-cause mortality 30, 180, and 365 days after surgery. Complementary log-log regression was used to identify participant characteristics and postoperative events associated with poorer survival.

RESULTS: Four hundred individuals had one of the urgent or emergency surgeries of interest, 24% of whom were aged 85 and older, 50% had coronary artery disease, 48% had cancer, 33% had congestive heart failure, and 37% experienced a postoperative complication. Postoperative mortality was 20% at 30 days, 31% at 180 days, and 34% at 365 days. Of those aged 85 and older, 50% were dead 1 year after surgery. After multivariate adjustment including postoperative complications, dementia (hazard ratio (HR) = 2.02, 95% confidence interval (CI) = 1.24-3.31), hospitalization within 6 months before surgery (HR = 1.63, 95% CI = 1.12-2.28), and complications (HR = 3.45, 95% CI = 2.32-5.13) were independently associated with worse 1-year survival.

CONCLUSION: Overall mortality is high in many older adults up to 1 year after undergoing emergency major abdominal surgery. The occurrence of a complication is the clinical factor most strongly associated with worse survival.

© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Keywords: 1-year mortality; emergency surgery; geriatric surgery; major abdominal surgery; surgical complications

References

  1. Dis Colon Rectum. 2011 Nov;54(11):1430-7 - PubMed
  2. J Am Geriatr Soc. 2009 May;57(5):830-9 - PubMed
  3. J Palliat Med. 2003 Apr;6(2):237-44 - PubMed
  4. Mt Sinai J Med. 2012 Jan-Feb;79(1):95-106 - PubMed
  5. Am J Epidemiol. 2012 Feb 1;175(3):228-35 - PubMed
  6. Ethn Dis. 2006 Autumn;16(4):900-8 - PubMed
  7. Surgery. 2012 Sep;152(3):465-72 - PubMed
  8. J Am Coll Surg. 2012 Oct;215(4):503-11 - PubMed
  9. Ann Surg. 2012 Sep;256(3):453-61 - PubMed
  10. JAMA. 2013 Apr 3;309(13):1379-87 - PubMed
  11. Ann Surg. 2003 Aug;238(2):170-7 - PubMed
  12. Ann Surg. 2005 Sep;242(3):326-41; discussion 341-3 - PubMed
  13. J Am Geriatr Soc. 2005 Mar;53(3):424-9 - PubMed
  14. Arch Intern Med. 2011 Nov 14;171(20):1854-6 - PubMed
  15. BMJ. 2009 Jan 22;338:b50 - PubMed
  16. Ann Surg. 2011 Aug;254(2):375-82 - PubMed
  17. World J Surg. 2005 Aug;29(8):1013-21; discussion 1021-2 - PubMed
  18. Med Care. 1998 Jan;36(1):8-27 - PubMed
  19. J Am Coll Surg. 2006 Dec;203(6):865-77 - PubMed
  20. JAMA Surg. 2014 Apr;149(4):319-26 - PubMed
  21. BMJ. 2010 Jan 18;340:c186 - PubMed
  22. Br J Cancer. 2012 Sep 4;107(6):931-6 - PubMed
  23. J Palliat Med. 2014 May;17(5):506-11 - PubMed
  24. World J Emerg Surg. 2013 Jul 01;8(1):23 - PubMed
  25. JAMA Surg. 2014 Jan;149(1):83-9 - PubMed
  26. Soc Sci Med. 2004 Sep;59(6):1297-306 - PubMed
  27. Alzheimer Dis Assoc Disord. 2004 Apr-Jun;18(2):90-8 - PubMed
  28. Ann Surg. 2013 Apr;257(4):766-73 - PubMed
  29. JAMA Surg. 2014 Feb;149(2):109-11 - PubMed
  30. Arch Surg. 2009 Dec;144(12):1108-14 - PubMed

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