Evidence map›Paper›PMID 38462583›Full record

Observational studyAging clinical and experimental research2024

Perioperative outcome, long-term mortality and time trends in elderly patients undergoing low-, intermediate- or major non-cardiac surgery.

E K M Tjeertes, T F W Simoncelli, A J M van den Enden, F U S Mattace-Raso, R J Stolker, S E Hoeks

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Aging clinical and experimental research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.8field-weighted citation impact, top 9% 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

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. 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

6 authors at 1 institution in 1 country.

E K M TjeertesDepartment of Anesthesiology, Erasmus MC University Medical Center, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
T F W SimoncelliDepartment of Anesthesiology, Erasmus MC University Medical Center, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
A J M van den EndenDepartment of Anesthesiology, Erasmus MC University Medical Center, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
F U S Mattace-RasoDivision of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
R J StolkerDepartment of Anesthesiology, Erasmus MC University Medical Center, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
S E HoeksDepartment of Anesthesiology, Erasmus MC University Medical Center, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands. s.hoeks@erasmusmc.nl.ORCID http://orcid.org/0000-0002-6845-5701
Erasmus MC · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDecision-making whether older patients benefit from surgery can be a difficult task. This report investigates characteristics and outcomes of a large cohort of inpatients, aged 80 years and over, undergoing non-cardiac surgery.

methodsThis observational study was performed at a tertiary university medical centre in the Netherlands. Patients of 80 years or older undergoing elective or urgent surgery from January 2004 to June 2017 were included. Outcomes were length of stay, discharge destination, 30-day and long-term mortality. Patients were divided into low-, intermediate and high-risk surgery subgroups. Univariable and multivariable logistic regression were used to evaluate the association of risk factors and outcomes. Secondary outcomes were time trends, assessed with Mantel-Haenszel chi-square test.

resultsData of 8251 patients, undergoing 19,027 surgical interventions were collected from the patients' medical record. 7032 primary procedures were suitable for analyses. Median LOS was 3 days in the low-risk group, compared to six in the intermediate- and ten in the high-risk group. Median LOS of the total cohort decreased from 5.8 days (IQR 1.9-14.5) in 2004-2007 to 4.6 days (IQR 1.9-9.0) in 2016-2017. Three quarters of patients were discharged to their home. Postoperative 30-day mortality in the low-risk group was 2.3%. In the overall population 30-day mortality was high and constant during the study period (6.7%, ranging from 4.2 to 8.4%).

conclusionPatients should not be withheld surgery solely based on their age. However, even for low-risk surgery, the mortality rate of more than 2% is substantial. Deciding whether older patients benefit from surgery should be based on the understanding of individual risks, patients' wishes and a patient-centred plan.

Indexed as

Postoperative ComplicationsAged, 80 and overHumansLength of StayNetherlandsRisk FactorsTime FactorsDischarge destinationElderly patientsLength of stayMortalitySurgerySurgical risk

Identifiers

PMID38462583
PMCPMC10925572
OpenAlexW4392632169

What OpenQuestion holds

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LicenceCC BY
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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.