ArticleJournal of the American Geriatrics Society2018
High Burden of Palliative Care Needs of Older Adults During Emergency Major Abdominal Surgery.
Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Palliative prognostic tools in surgical patients at the end of life: a systematic review.British journal of anaesthesia · 2025Pooled it
- Public-private healthcare utilisation and satisfaction among older adults with palliative care needs in India: a study based on Longitudinal Ageing Study in India.BMC health services research · 2026Article
- Palliative care in acute care surgery: research challenges and opportunities.Trauma surgery & acute care open · 2025Review
- Enhanced Recovery After Surgery (ERAS®) Society Consensus Guidelines for Emergency Laparotomy Part 3: Organizational Aspects and General Considerations for Management of the Emergency Laparotomy Patient.World journal of surgery · 2023Review
- Prevalence of unpaid caregiving, pain, and depression in older seriously ill patients undergoing elective surgery.Journal of the American Geriatrics Society · 2023Article
- What If We Do Not Operate? Outcomes of Nonoperatively Managed Emergency General Surgery Patients.The Journal of surgical research · 2023Article
- Functional Status is Key to Long-term Survival in Emergency General Surgery Conditions.The Journal of surgical research · 2023Article
- Narrative review of palliative care in trauma and emergency general surgery.Annals of palliative medicine · 2022Review
- Preoperative Frailty Status and Intensity of End-of-Life Care Among Older Adults After Emergency Surgery.Journal of pain and symptom management · 2021Article
- Early Postoperative Death in Patients Undergoing Emergency High-Risk Surgery: Towards a Better Understanding of Patients for Whom Surgery May Not Be Beneficial.Journal of clinical medicine · 2020Article
- Mortality and Health Care Utilization Among Medicare Patients Undergoing Emergency General Surgery vs Those With Acute Medical Conditions.JAMA surgery · 2020Article
- Observational
- Concordant palliative care delivery in advanced head and neck cancer.American journal of otolaryngologyArticle
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo quantify preoperative illness burden in older adults undergoing emergency major abdominal surgery (EMAS), to examine the association between illness burden and postoperative outcomes, and to describe end-of-life care in the year after discharge.
designRetrospective study using data from Health and Retirement Study interviews linked to Medicare claims (2000-2012).
settingNational population-based dataset.
participantsMedicare beneficiaries who underwent EMAS. MEASUREMENTS: High illness burden, defined as ≥2 of the following vulnerabilities: functional dependence, dementia, use of helpers, multimorbidity, poor prognosis, high healthcare utilization. In-hospital outcomes were complications and mortality. Postdischarge outcomes included emergency department (ED) visits, hospitalization, intensive care unit (ICU) stay, and 365-day mortality. For individuals discharged alive who died within 365 days of surgery, outcomes included hospice use, hospitalization, ICU use, and ED use in the last 30 days of life. Multivariable regression was used to determine the association between illness burden and outcomes.
resultsOf 411 participants, 57% had high illness burden. More individuals with high illness burden had complications (45% vs 28% p=0.00) and in-hospital death (20% vs 9%, p=0.00) than those without. After discharge (n=349), individuals with high illness burden experienced more ED visits (57% vs 46%, P=.04) and were more likely to die (35% vs 13%, p=0.00). Of those who died after discharge (n=86), 75% had high illness burden, median survival was 67 days (range 21-141 days), 48% enrolled in hospice, 32% died in the hospital, 23% were in the ICU in the last 30 days of life and 37% had an ED visit in the last 30 days of life.
conclusionMost older adults undergoing EMAS have preexisting high illness burden and experience high mortality and healthcare use in the year after surgery, particularly near the end of life. Concurrent surgical and palliative care may improve quality of life and end-of-life care in these people. J Am Geriatr Soc 66:2072-2078, 2018.
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