ArticleJournal of the American Geriatrics Society2019
High-Risk Comorbidity Combinations in Older Patients Undergoing Emergency General Surgery.
Article in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07456215 (The Effect of Platelet Rich Plasma), which is not on this map. Cited by 41 papers.
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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.
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.
The Effect of Platelet Rich Plasma (PRP) Application on Rotator Cuff Tear.
Who cites it
41 citing papers in PubMed.
- Observational
- Recovery Experiences of Older Adults and Their Caregivers After Major Elective Noncardiac Surgery.JAMA network open · 2026Article
- Team-Based Long-Term Multidisciplinary Inpatient Neurological Rehabilitation After Surgery of Cerebral Meningioma-Outcome and Confounding Factors.Brain sciences · 2026Article
- Percutaneous transhepatic cholangioscopy-guided holmium laser lithotripsy for bile duct stones in elderly patients.PloS one · 2026Article
- A Nurse-Guided, Family-Involved Individualized Perioperative Management Multidisciplinary Team Model in Older Patients Underwent Cardiac Surgery.Journal of multidisciplinary healthcare · 2026Article
- Development of a machine learning algorithm model to predict intraoperative hypotension in elderly patients undergoing thoracic and abdominal surgeries.Open medicine (Warsaw, Poland) · 2026Article
- Association of Frailty and Postoperative Outcomes across Race and Ethnicity.Journal of racial and ethnic health disparities · 2025Article
- Patients With Dementia Undergoing High-Risk Inpatient Surgery Have Poor Outcomes.Journal of the American Geriatrics Society · 2025Article
- Associations of multimorbidity with mortality, hospital stay, and hospitalization costs in Chinese surgical patients: a retrospective cohort study.BMC anesthesiology · 2025Observational
- Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia.BMC public health · 2025Article
- Factors associated with pressure ulcers among middle-old and oldest-old inpatients in an acute care hospital.Scientific reports · 2025Article
- Article
- Characterizing patients at higher cardiovascular risk for prescribed stimulants: Learning from health records data with predictive analytics and data mining techniques.Computers in biology and medicine · 2025Article
- Effect of Nationwide Postoperative Rehabilitation at Home Program after Lower Extremity Surgeries in Older and Younger People.Annals of geriatric medicine and research · 2025Article
- Identifying those at risk: predicting patient factors associated with worse EGS outcomes.Trauma surgery & acute care open · 2025Article
- The effect of comorbidity on 28-day perioperative mortality rate among non-cardiac surgical patients in Northwest Ethiopia: a prospective cohort study using propensity score matching.BMC public health · 2024Article
- The Association of Established Primary Care with Postoperative Outcomes Among Medicare Patients with Digestive Tract Cancer.Annals of surgical oncology · 2024Article
- Trends and Disparities in the Utilization of Thymectomy for Myasthenia Gravis in the United States.Neurology. Clinical practice · 2024Article
- Pre-Therapeutic Assessment of Older People in Sub-Saharan Africa: Introduction to the Comprehensive Geriatric Assessment.Journal of clinical medicine · 2024Review
- Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND/
objectivesOver a million older patients in the United States are admitted yearly for emergency general surgery (EGS) conditions. Seven procedure types dominate: colon, small bowel, gallbladder, ulcer disease, adhesiolysis, appendix, and laparotomy operations. A higher comorbidity burden is known to increase mortality in this population, but the impact of specific comorbidity combinations is unknown. Our objectives were to (1) characterize the distribution of procedures, comorbidities, and outcomes for older patients undergoing EGS; and (2) apply a data-driven approach (association rule mining) to identify comorbidity combinations associated with disproportionately high mortality. DESIGN, SETTING, AND
participantsCross-sectional study of patients 65 years and older who underwent one of the seven procedures previously cited, taken from the 2011 Nationwide Inpatient Sample. A total of 280 885 patient encounters were identified. MEASUREMENTS: In-hospital mortality, procedures, and comorbidities based on the Elixhauser Comorbidity Index.
resultsOverall mortality was 5.6%. The most common procedures were gallbladder (33.7%), ulcer surgery (21.5%), and adhesiolysis (21.0%). Mortality increased for all procedures as patients aged. Comorbidities associated with the highest mortality included coagulopathy (adjusted odds ratio [aOR] = 3.74; 95% confidence interval [CI] = 3.41-4.11; p < .001), fluid and electrolyte disorders (FED) (aOR = 2.89; 95% CI = 3.66-3.14; p < .001), and liver disease (aOR = 1.89; 95% CI = 1.61-2.22; p < .001). Three-way comorbidity combinations most highly associated with mortality were coagulopathy, FED, and peripheral vascular disease (aOR = 5.10; 95% CI = 4.17-6.24; p < .001), and coagulopathy, FED, and chronic pulmonary disease (aOR = 4.83; 95% CI = 4.00-5.82; p < .001).
conclusionFor older patients, combinations of comorbidities portend additional risk beyond single comorbidities, and the associated risk burden is driven by the specific constellation of comorbidities present. Future work must continue to examine the effect of co-occurring diseases to provide personalized and realistic prognostication for older patients undergoing EGS. J Am Geriatr Soc 67:503-510, 2019.
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