Evidence map›Paper›PMID 35723857›Full record

ArticleAging clinical and experimental research2022

The clinical impact of frailty on the postoperative outcomes of patients undergoing appendectomy: propensity score-matched analysis of 2011-2017 US hospitals.

David Uihwan Lee, David Jeffrey Hastie, Ki Jung Lee, Gregory Hongyuan Fan, Elyse Ann Addonizio, John Han, Julie Suh, Raffi Karagozian

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Article in Aging clinical and experimental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.4field-weighted citation impact, top 21% of its field
1 · What the graph read from 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.

2 · The registry

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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

1 citing paper in PubMed, 11 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

David Uihwan LeeDivision of Gastroenterology and Hepatology, University of Maryland, 22 S Greene St, Baltimore, MD, 21201, USA. dvleeman@gmail.com.ORCID http://orcid.org/0000-0001-7129-7532
David Jeffrey HastieLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Ki Jung LeeLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Gregory Hongyuan FanLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Elyse Ann AddonizioLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
John HanLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Julie SuhLiver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Raffi KaragozianDivision of Gastroenterology and Hepatology, University of Maryland, 22 S Greene St, Baltimore, MD, 21201, USA.
Tufts Medical Center · USUniversity of Maryland, Baltimore · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe presence of clinical frailty can pose an escalated risk toward surgical outcomes including in cases that involve minimally invasive procedures. Given this premise, we evaluate the effects of frailty on post-appendectomy outcomes using a national in-hospital registry.

methods2011-2017 National Inpatient Sample was used to isolate inpatient appendectomy cases; the population as stratified using Johns Hopkins ACG clinical frailty, expressed as either binary or ternary (prefrailty, frailty, and without frailty) indicators. The controls were matched to frailty-present groups using propensity score matching and compared to various endpoints, including mortality, length of stay (LOS), hospitalization costs, and postoperative complications.

resultsPost-match, there were 11,758 with and without frailty per binary; and 1236 frail, 10,522 pre-frail with respective equal number controls per ternary indicator. Using binary term, frail patients had higher mortality (4.22 vs 1.49% OR 2.92 95%CI 2.45-3.47), LOS (14.3 vs 5.35d p < 0.001), and costs ($160,700 vs $64,141 p < 0.001). In multivariate, frail patients had higher mortality (aOR 2.77 95%CI 2.32-3.31), as well as higher rates of postoperative complications. Using ternary term, frail patients had higher mortality (5.02 vs 2.27% OR 2.28 95%CI 1.45-3.59), LOS (18.9 vs 5.66 day p < 0.001) and costs ($200,517 vs $66,193 p < 0.001). In multivariate, frail patients had higher mortality (aOR 2.16 95%CI 1.35-3.43) and complications. Those with pre-frailty had higher mortality (4.12 vs 1.47% OR 2.88 95%CI 2.39-3.46), LOS (13.8 vs 5.34 day p < 0.001) and costs ($156,022 vs $63,772 p < 0.001). In multivariate, pre-frailty patients had higher mortality (aOR 2.79 95%CI 2.31-3.37) and complications.

conclusionsFrailty and prefrailty (using the ternary indicator) are associated with increased postoperative mortality and complication in patients who undergo appendectomy; given this finding, it is imperative that these vulnerable patients are identified early in the preoperative phase and are provided risk-modifying measures to ameliorate risks and optimize outcomes.

Indexed as

FrailtyAppendectomyHospitalsHumansLength of StayPostoperative ComplicationsPropensity ScoreRetrospective StudiesRisk FactorsDecubitus ulcersLaparoscopic appendectomyMalnutritionOpen appendectomySurgical outcomes in the elderly

Identifiers

PMID35723857
OpenAlexW4283167269

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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.