Evidence map›Paper›PMID 34427823›Full record

ArticleAnnals of surgical oncology2021

A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery.

Bourke W Tillmann, Julie Hallet, Matthew P Guttman, Natalie Coburn, Tyler Chesney, Jesse Zuckerman, Alyson Mahar, Victoria Zuk, Wing C Chan, Barbara Haas and 1 more

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In one paragraph

Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Bourke W TillmannInterdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada. Bourke.tillmann@sunnybrook.ca.ORCID http://orcid.org/0000-0002-7815-5972
Julie HalletInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Matthew P GuttmanInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Natalie CoburnInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Tyler ChesneyDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Jesse ZuckermanInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Alyson MaharDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Victoria ZukClinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
Wing C ChanICES, Toronto, ON, Canada.
Barbara HaasInterdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
and members of the REcovery after Surgical Therapy for Older adults Research—Cancer (RESTORE-C) group

Funding

Ontario Institute for Cancer Research P.HSR.156
6 · The paper itself

Abstract

backgroundHigh-intensity cancer surgery is increasingly common among older adults. However, these patients are at high-risk for unexpected intensive care unit (ICU) admissions after surgery. How these admissions impact older adults' long-term outcomes is unknown.

methodsWe performed a population-based, cohort study of older adults (age ≥ 70 years) who underwent high-intensity cancer surgery from 2007 to 2017. Analyses were performed to examine time alive and at home following surgery, defined as time from surgery to nursing home admission or death. Patients were followed for up to 5 years. Extended Cox proportional hazards models examined the independent association between unexpected ICU admission (ICU admissions excluding routine postoperative monitoring) and remaining alive and at home. Subgroup analysis stratified patients by duration of mechanical ventilation (MV).

resultsOf 47,367 identified older adults, 7372 (15.6%) had an unexpected ICU admission. Patients with an unexpected ICU admission had a significantly lower probability of being alive and at home at 5 years (26.2%; 95% confidence interval [CI] 25.1-27.2%) compared with those without an unexpected admission (56.8%; 95% CI 56.3-57.4%). After adjusting for baseline characteristics, unexpected ICU admission remained associated with less time alive and at home. The elevated risk of death or nursing home admission persisted for 5 years after surgery (years 2-5: hazard ratio [HR] 1.58, 95% CI 1.50-1.66). Duration of MV was inversely associated with time alive and at home.

conclusionsOlder adults with an unexpected ICU admission after high-intensity cancer surgery are at increased risk for death or admission to a nursing home for at least 5 years.

Indexed as

HospitalizationNeoplasmsAgedCohort StudiesHumansIntensive Care UnitsProportional Hazards ModelsCritical careIndependent livingNeoplasm/surgeryOlder adultsRecovery of function

Identifiers

PMID34427823

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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.