{"title":"合并症和功能状态对老年普外科急诊患者预后的影响","authors":"","doi":"10.1016/j.amjsurg.2024.115903","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study is to quantify the relative contribution of comorbidities and pre-operative functional status on outcomes in geriatric emergency general surgery (EGS) patients.</p></div><div><h3>Methods</h3><p>This is a retrospective study of older-adult EGS patients at an academic medical center between 2017 and 2018. Patients ≥65 years were included. The primary outcomes examined were 30-day mortality, 30-day morbidity, and length of stay (LOS).</p></div><div><h3>Results</h3><p>734 patients were included. The mean age was 76, and 48.9 % received non-operative management. The median LOS was 6.8 days; 11.8 % of patients died within 30 days, and 40.6 % developed morbidities. Lacking capacity to consent on admission was independently associated with 30-day mortality (OR: 2.63, [1.32–5.25], p = 0.006). Comorbidities associated with developing morbidity were CVA with neurologic deficit (OR: 2.29, [1.20–4.36], p = 0.012), CHF (OR: 2.60, [1.64–4.11], p < 0.001), in addition to pre-operative delirium (OR: 3.42, [1.43–8.14], p = 0.006).</p></div><div><h3>Conclusions</h3><p>A significant contribution to outcomes is determined by pre-admission comorbidities and cognitive and functional status. Opportunities exist for collaboration between Acute Care Surgery and geriatric medicine teams for the optimization of comorbidities.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of comorbidities and functional status on outcomes in the older adult emergency general surgery patient\",\"authors\":\"\",\"doi\":\"10.1016/j.amjsurg.2024.115903\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The aim of this study is to quantify the relative contribution of comorbidities and pre-operative functional status on outcomes in geriatric emergency general surgery (EGS) patients.</p></div><div><h3>Methods</h3><p>This is a retrospective study of older-adult EGS patients at an academic medical center between 2017 and 2018. Patients ≥65 years were included. The primary outcomes examined were 30-day mortality, 30-day morbidity, and length of stay (LOS).</p></div><div><h3>Results</h3><p>734 patients were included. The mean age was 76, and 48.9 % received non-operative management. The median LOS was 6.8 days; 11.8 % of patients died within 30 days, and 40.6 % developed morbidities. Lacking capacity to consent on admission was independently associated with 30-day mortality (OR: 2.63, [1.32–5.25], p = 0.006). Comorbidities associated with developing morbidity were CVA with neurologic deficit (OR: 2.29, [1.20–4.36], p = 0.012), CHF (OR: 2.60, [1.64–4.11], p < 0.001), in addition to pre-operative delirium (OR: 3.42, [1.43–8.14], p = 0.006).</p></div><div><h3>Conclusions</h3><p>A significant contribution to outcomes is determined by pre-admission comorbidities and cognitive and functional status. Opportunities exist for collaboration between Acute Care Surgery and geriatric medicine teams for the optimization of comorbidities.</p></div>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-08-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002961024004550\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961024004550","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
The impact of comorbidities and functional status on outcomes in the older adult emergency general surgery patient
Background
The aim of this study is to quantify the relative contribution of comorbidities and pre-operative functional status on outcomes in geriatric emergency general surgery (EGS) patients.
Methods
This is a retrospective study of older-adult EGS patients at an academic medical center between 2017 and 2018. Patients ≥65 years were included. The primary outcomes examined were 30-day mortality, 30-day morbidity, and length of stay (LOS).
Results
734 patients were included. The mean age was 76, and 48.9 % received non-operative management. The median LOS was 6.8 days; 11.8 % of patients died within 30 days, and 40.6 % developed morbidities. Lacking capacity to consent on admission was independently associated with 30-day mortality (OR: 2.63, [1.32–5.25], p = 0.006). Comorbidities associated with developing morbidity were CVA with neurologic deficit (OR: 2.29, [1.20–4.36], p = 0.012), CHF (OR: 2.60, [1.64–4.11], p < 0.001), in addition to pre-operative delirium (OR: 3.42, [1.43–8.14], p = 0.006).
Conclusions
A significant contribution to outcomes is determined by pre-admission comorbidities and cognitive and functional status. Opportunities exist for collaboration between Acute Care Surgery and geriatric medicine teams for the optimization of comorbidities.
期刊介绍:
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.