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Impact of surgery on older patients hospitalized with an acute abdomen: findings from the Older Persons Surgical Outcome Collaborative

Tray, Hui Sian, Wood, Adrian D., Carter, Ben, Pearce, Lyndsay, McCarthy, Kathrlyn, Stechman, Michael J., Myint, Phyo K. and Hewitt, Jonathan ORCID: 2020. Impact of surgery on older patients hospitalized with an acute abdomen: findings from the Older Persons Surgical Outcome Collaborative. Frontiers in Surgery 7 , 583653. 10.3389/fsurg.2020.583653

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Background: The impact of surgical operation on older people presenting as general surgical patients compared to non-surgical management is less well researched.Methods: We examined the association between management and adverse outcomes in a cohort of emergency general surgery patients aged>65 years. This multi-center study included 727 patients (mean+/-SD, 77.1±8.2 years, 54% female) admitted to five UK hospitals. Data were analyzed using multi-level crude and multivariable logistic regression. Outcomes included: mortality at Day 30 and 90, length of stay, and readmission within 30 days of discharge. Covariates assessed were management approach, age, sex, frailty, polypharmacy, anemia, and hypoalbuminemia.Results: Approximately 25% of participants (n=185) underwent emergency surgery. Frailty and albumin were associated with mortality at 30 (frailty OR=3.52 [95%CI 1.66-7.49], albumin OR=3.78 ([95%CI 1.53-9.31]), and 90 days post discharge (frailty OR=3.20 [95%CI 1.86-5.51], albumin OR=3.25 [95%CI 1.70-6.19]) and readmission (frailty OR=1.56 [[95%CI (1.04-2.35)]. Surgically managed patients and frailty had increased odds of prolonged hospitalization (surgery OR=5.69 [95%CI 3.67-8.80], frailty OR=2.17 [95%CI 1.46-3.23]).Conclusion: We found the impact of surgery on length of hospitalisation in older surgical patients is substantial. Whether early comprehensive geriatric assessment and post-op rehabilitation would improve this outcome require further evaluation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Frontiers Media
ISSN: 2296-875X
Date of First Compliant Deposit: 25 September 2020
Date of Acceptance: 22 September 2020
Last Modified: 07 Nov 2022 11:16

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