ArticleJournal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia2018
Surgical outcomes for patients diagnosed with dementia: A coarsened exact matching study.
Article in Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Racial and Sex Differences in Postoperative Mortality Between Patients With Versus Without Dementia.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Decision making in chronic subdural haematoma patient referrals in an octogenarian and nonagenarian population - a multi-centre perspective.Irish journal of medical science · 2026Article
- Patients With Dementia Undergoing High-Risk Inpatient Surgery Have Poor Outcomes.Journal of the American Geriatrics Society · 2025Article
- Patients living with dementia have worse outcomes when undergoing high-risk procedures.Journal of the American Geriatrics Society · 2022Article
- Association of Multimorbidity With Frailty in Older Adults for Elective Non-Cardiac Surgery.Cureus · 2021Article
- Defining Serious Illness Among Adult Surgical Patients.Journal of pain and symptom management · 2019Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAn increasing number of elderly patients with dementia are undergoing surgical operations. Little is known about the differential impact of dementia on surgical outcomes. We investigated whether demented patients undergoing surgical operations have worse outcomes than their non-demented counterparts.
methodsWe performed a cohort study of all patients undergoing a series of surgical operations who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2009 to 2013. We examined the association of dementia with inpatient case-fatality, discharge to a facility, and length of stay (LOS). Coarsened exact matching was used to balance comorbidities among the comparison groups, and mixed effect methods were used to control for clustering at the hospital level.
resultsDuring the study period, 342,075 patients underwent surgical operations that met the inclusion criteria. Multivariable logistic regression models, after coarsened exact matching, demonstrated that demented patients were not associated with higher case-fatality (OR, 0.43; 95% CI, 0.13-1.36), but were associated with higher rates of discharge to a facility (OR, 1.71; 95% CI, 1.26-2.31) and longer LOS (Adjusted difference, 31%; 95% CI, 26%-36%). These persisted in pre-specified subgroups stratified on particular operations.
conclusionsUsing a comprehensive all-payer cohort of surgical patients in New York State we identified an association of dementia with increased rate of discharge to rehabilitation and longer LOS. No difference was identified in the case fatality of the two groups. Policy makers, payers, and physicians should take these findings into account when designing new policies, and when counseling patients.
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