Evidence map›Paper›PMID 36473737›Full record

Observational studyAmerican journal of surgery2023

Examining disparities among older multimorbid emergency general surgery patients: An observational study of Medicare beneficiaries.

Sanford E Roberts, Claire B Rosen, Christopher J Wirtalla, Caitlin B Finn, Elinore J Kaufman, Patrick M Reilly, Solomiya Syvyk, Matthew D McHugh, Rachel R Kelz

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in American journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 28% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Review
  3. Racial and Ethnic Disparities in the Diagnosis and Treatment of Thyroid Disease.The Journal of clinical endocrinology and metabolism · 2024
    Review
  4. Article
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

9 authors at 2 institutions in 1 country.

Sanford E RobertsCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: Sanford.roberts@pennmedicine.upenn.edu.
Claire B RosenCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Christopher J WirtallaCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Caitlin B FinnCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Elinore J KaufmanCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Patrick M ReillyCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Solomiya SyvykCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Matthew D McHughCenter for Health Outcomes & Policy Research, University of Pennsylvania School of Nursing, University of Pennsylvania, USA.
Rachel R KelzCenter for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA; Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
University of Pennsylvania · USUniversity of Pennsylvania Health System · US

Funding

Using Outcomes to Guide Treatment of Surgical EmergenciesR01AG060612 · NIA · UNIVERSITY OF PENNSYLVANIA · PI KELZ, RACHEL · 2019 to 2023
$2.7M
Emergency General Surgery Treatment of Older Multimorbid PatientsF32AG074614 · NIA · UNIVERSITY OF PENNSYLVANIA · PI ROSEN, CLAIRE · 2021 to 2022
$149k
NIA NIH HHS F32 AG074614NIA NIH HHS L60 AG079461NIA NIH HHS R01 AG060612
6 · The paper itself

Abstract

backgroundQualifying comorbidity sets (QCS) are tools used to identify multimorbid patients at increased surgical risk. It is unknown how the QCS framework for multimorbidity affects surgical risk in different racial groups.

methodsThis retrospective cohort study included Medicare patients age ≥65.5 who underwent an emergency general surgery operation from 2015 to 2018. Our exposure was race and multimorbidity, included in our model as an interaction term. The primary outcome of the study was 30-day mortality. Secondary outcomes included routine discharge, 30-day readmission, length of stay, and complications.

resultsIn total, 163,148 patients who underwent and operation were included in this study. Of these, 13,852 (8.5%, p < 0.001) were Black, and 149,296 (91.5%, p < 0.001) were White. Black multimorbid patients had no significant differences in 30-day mortality, routine discharge or 30-day readmission when compared to White multimorbid patients after risk-adjustment. Black multimorbid patients had significantly lower odds of complications (OR 0.89, p = 0.014) compared to White multimorbid patients.

conclusionsOur study of universally insured patients highlights the critical role of pre-operative health status and its association with surgical outcomes.

Indexed as

MedicareMultimorbidityAgedHealthcare DisparitiesHumansPatient ReadmissionRacial GroupsRetrospective StudiesUnited StatesBlackEmergencyGeneral surgeryMultimorbidityOlder ageRaceWhite

Identifiers

PMID36473737
PMCPMC10199957
OpenAlexW4309776981

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.