Evidence map›Paper›PMID 38365289›Full record

ArticleBMJ open2024

Changes in surgical mortality during COVID-19 pandemic by patients' race, ethnicity and socioeconomic status among US older adults: a quasi-experimental event study model.

Mariah B Blegen, Jordan M Rook, Nicholas J Jackson, Melinda Maggard-Gibbons, Ruixin Li, Marcia M Russell, Tara A Russell, Christian de Virgilio, Yusuke Tsugawa

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2024. 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
0.6field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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.

Mariah B BlegenVA Greater Los Angeles Healthcare System, Los Angeles, California, USA MBlegen@mednet.ucla.edu.ORCID 0000-0003-1213-3866
Jordan M RookVA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Nicholas J JacksonVA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Melinda Maggard-GibbonsVA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Ruixin LiDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Marcia M RussellVA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Tara A RussellDepartment of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Christian de VirgilioDepartment of Surgery, Los Angeles County Harbor-UCLA Medical Center, Torrance, California, USA.
Yusuke TsugawaDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
University of California, Los Angeles · USUCLA Medical Center · US

Funding

The Impact of Surgeon Factors and Education/Training on Disparities in Surgical Care.R01MD013913 · NIMHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI TSUGAWA, YUSUKE · 2020 to 2024
$3.6M
The Impact of physician and health system factors on the quality of care for persons with Alzheimer's disease and related dementias at the end of lifeR01AG068633 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI TSUGAWA, YUSUKE · 2020 to 2024
$3.0M
The effect of medical school, residency program, and health system board diversities on racial and ethnic disparities in AD/ADRD care.R01AG082991 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Yusuke Tsugawa · 2023 to 2026
$2.1M
NIA NIH HHS R01 AG068633NIA NIH HHS R01 AG082991NIMHD NIH HHS R01 MD013913
6 · The paper itself

Abstract

objectivesTo examine changes in the 30-day surgical mortality rate after common surgical procedures during the COVID-19 pandemic and investigate whether its impact varies by urgency of surgery or patient race, ethnicity and socioeconomic status.

designWe used a quasi-experimental event study design to examine the effect of the COVID-19 pandemic on surgical mortality rate, using patients who received the same procedure in the prepandemic years (2016-2019) as the control, adjusting for patient characteristics and hospital fixed effects (effectively comparing patients treated at the same hospital). We conducted stratified analyses by procedure urgency, patient race, ethnicity and socioeconomic status (dual-Medicaid status and median household income).

settingAcute care hospitals in the USA.

participantsMedicare fee-for-service beneficiaries aged 65-99 years who underwent one of 14 common surgical procedures from 1 January 2016 to 31 December 2020.

main outcome measures30-day postoperative mortality rate.

resultsOur sample included 3 620 689 patients. Surgical mortality was higher during the pandemic, with peak mortality observed in April 2020 (adjusted risk difference (aRD) +0.95 percentage points (pp); 95% CI +0.76 to +1.26 pp; p<0.001) and mortality remained elevated through 2020. The effect of the pandemic on mortality was larger for non-elective (vs elective) procedures (April 2020: aRD +0.44 pp (+0.16 to +0.72 pp); p=0.002 for elective; aRD +1.65 pp (+1.00, +2.30 pp); p<0.001 for non-elective). We found no evidence that the pandemic mortality varied by patients' race and ethnicity (p for interaction=0.29), or socioeconomic status (p for interaction=0.49).

conclusions30-day surgical mortality during the COVID-19 pandemic peaked in April 2020 and remained elevated until the end of the year. The influence of the pandemic on surgical mortality did not vary by patient race and ethnicity or socioeconomic status, indicating that once patients were able to access care and undergo surgery, surgical mortality was similar across groups.

Indexed as

COVID-19EthnicityAgedHumansMedicarePandemicsSocial ClassUnited StatesCOVID-19mortalitysurgery

Identifiers

PMID38365289
PMCPMC10882376
OpenAlexW4391886653

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.