ArticleJournal of pain and symptom management2021
Preoperative Frailty Status and Intensity of End-of-Life Care Among Older Adults After Emergency Surgery.
Article in Journal of pain and symptom management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Impact of patient education and care on quality of life and mental well-being in cancer patients undergoing radiotherapy: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Palliative prognostic tools in surgical patients at the end of life: a systematic review.British journal of anaesthesia · 2025Pooled it
- Palliative Care for Older Adults With Hip Fracture: An Explanatory Sequential Mixed-Methods Study.Journal of pain and symptom management · 2026Article
- From Emergency Department to Operating Room: The Role of Early Prehabilitation and Perioperative Care in Emergency Laparotomy: A Scoping Review and Practical Proposal.Journal of clinical medicine · 2025Review
- Review
- Days at home after surgery as a perioperative outcome: scoping review and recommendations for use in health services research.The British journal of surgery · 2024Article
- Claims-Based Frailty Index and Its Relationship With Commonly Used Clinical Frailty Measures.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- 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
- Heath status, frailty, and multimorbidity in patients with emergency general surgery conditions.Surgery · 2022Article
- Narrative review of palliative care in trauma and emergency general surgery.Annals of palliative medicine · 2022Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
contextEmergency general surgery (EGS) is common and highly morbid for older adults, particularly for those who are frail. However, there are little data on the quality of end-of-life care (EOLC) for this population.
objectivesWe sought to examine the association of frailty with intensity of EOLC for older adults with and without frailty who undergo EGS but die within one year.
methodsThis retrospective cohort study included 100% Medicare fee-for-service beneficiaries, ≥66 years, who underwent one of five EGS procedures with the highest mortality (partial colectomy, small bowel resection, peptic ulcer disease repair, adhesiolysis, or laparotomy) between 2008 and 2014 and died within one year. A validated claims-based frailty index (CFI) identified patients who were not frail (CFI < 0.15), prefrail (0.15 ≤ CFI < 0.25), mildly frail (0.25 ≤ CFI < 0.35), and moderately to severe frail (CFI ≥ 0.35). Multivariable adjusted logistic or Poisson regression compared post-discharge and EOL healthcare utilization.
resultsAmong 138,916 older EGS adults who died within one year, 32.2% were not frail, 31.7% were prefrail, 29.8% had mild frailty and 6.3% had moderate-to-severe frailty. Decedents with any degree of frailty experienced high-intensity EOLC (P < 0.01), low rates of hospice use (P < 0.01), and fewer days at home. Of those who survived the index hospitalization but died within one year, moderate-to-severely frail decedents had the highest odds of visiting an emergency department (odds ratio [OR] = 1.19, CI = 1.13-1.27), rehospitalization (OR = 1.23, CI = 1.16-1.31), or an intensive care unit admission (OR = 1.22, CI = 1.13-1.30) in the last 30 days of life compared to nonfrail decedents.
conclusionWhile all older patients undergoing EGS have poor end-of-life outcomes, frail EGS patients receive the highest intensity EOLC and represent a vulnerable population for whom targeted interventions could limit burdensome treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.