Evidence map›Paper›PMID 36423470›Full record

ArticleThe Journal of surgical research2023

Functional Status is Key to Long-term Survival in Emergency General Surgery Conditions.

Vanessa P Ho, Wyatt P Bensken, J Alford Flippin, Heena P Santry, Jeffrey A Claridge, Christopher W Towe, Siran M Koroukian

Open access · greenAbstract read
In one paragraph

Article in The Journal of surgical research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 33% of its field
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Vanessa P HoDepartment of Surgery, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio. Electronic address: vho@metrohealth.org.
Wyatt P BenskenDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio.
J Alford FlippinDepartment of Surgery, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio.
Heena P SantryDepartment of Surgery, Kettering Hospital, Columbus, Ohio.
Jeffrey A ClaridgeDepartment of Surgery, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio.
Christopher W ToweDepartment of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio.
Siran M KoroukianDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio.
MetroHealth Medical Center · USCase Western Reserve University · USUniversity Hospitals of Cleveland · US

Funding

TUMOR METABOLISM PROGRAMP30CA043703 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI MARK R CHANCE · 1987 to 2026
$142.3M
Institutional Career Development CoreKL2TR002547 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI DWEIK, RAED A. · 2018 to 2022
$7.7M
Multi-Level Interventions to Reduce Caries Disparities in Primary Care SettingsUH3DE025487 · NIDCR · CASE WESTERN RESERVE UNIVERSITY · PI NELSON, SUCHITRA S. · 2017 to 2021
$5.6M
Identifying Electronic Phenotypes associated with Patient Health Outcomes of Interhospital Transfer PatientsR15NR017792 · NINR · CASE WESTERN RESERVE UNIVERSITY · PI REIMER, ANDREW PAUL · 2018 to 2018
$477k
ACL HHS U48DP005030ACL HHS U48DP006404NCATS NIH HHS KL2 TR002547NCCDPHP CDC HHS U48 DP005030NCCDPHP CDC HHS U48 DP006404NCI NIH HHS P30 CA043703NIDCR NIH HHS UH3 DE025487NINR NIH HHS R15 NR017792
6 · The paper itself

Abstract

introductionEmergency General Surgery (EGS) conditions in older patients constitutes a substantial public health burden due to high morbidity and mortality. We sought to utilize a supervised machine learning method to determine combinations of factors with the greatest influence on long-term survival in older EGS patients.

methodsWe identified community dwelling participants admitted for EGS conditions from the Medicare Current Beneficiary Survey linked with claims (1992-2013). We categorized three binary domains of multimorbidity: chronic conditions, functional limitations, and geriatric syndromes (such as vision or hearing impairment, falls, incontinence). We also collected EGS disease type, age, and sex. We created a classification and regression tree (CART) model to identify groups of variables associated with our outcome of interest, three-year survival. We then performed Cox proportional hazards analysis to determine hazard ratios for each group with the lowest risk group as reference.

resultsWe identified 1960 patients (median age 79 [interquartile range [IQR]: 73, 85], 59.5% female). The CART model identified the presence of functional limitations as the primary splitting variable. The lowest risk group were patient aged ≤81 y with biliopancreatic disease and without functional limitations. The highest risk group was men aged ≥75 y with functional limitations (hazard ratio [HR] 11.09 (95% confidence interval [CI] 5.91-20.83)). Notably absent from the CART model were chronic conditions and geriatric syndromes.

conclusionsMore than the presence of chronic conditions or geriatric syndromes, functional limitations are an important predictor of long-term survival and must be included in presurgical assessment.

Indexed as

General SurgeryMedicareAgedChronic DiseaseFunctional StatusGeriatric AssessmentHumansMaleRisk FactorsSyndromeUnited StatesEmergency general surgeryFrailtyFunctional statusGeriatric surgeryMultimorbidity

Identifiers

PMID36423470
PMCPMC9923717
OpenAlexW4309775114

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.