Surgical outcomes and healthcare expenditures among patients with dementia undergoing major surgery

Background We sought to define surgical outcomes among elderly patients with Alzheimer's disease and related dementias (ADRD) following major thoracic and gastrointestinal surgery. Methods A retrospective cohort study was used to identify patients who underwent coronary artery bypass grafting (...

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Bibliographic Details
Published in:World journal of surgery 2024-05, Vol.48 (5), p.1075-1083
Main Authors: Khalil, Mujtaba, Woldesenbet, Selamawit, Munir, Muhammad Musaab, Katayama, Erryk, Mehdi Khan, Muhammad Muntazir, Altaf, Abdullah, Rashid, Zayed, Endo, Yutaka, Dillhoff, Mary, Tsai, Susan, Pawlik, Timothy M.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer Disease - economics
dementia
Dementia - economics
Digestive System Surgical Procedures - economics
Female
geriatric care
Health Expenditures - statistics & numerical data
healthcare expenditures
Humans
major surgery
Male
Medicare - economics
Postoperative Complications - economics
Postoperative Complications - epidemiology
Propensity Score
Retrospective Studies
Treatment Outcome
United States
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Summary:Background We sought to define surgical outcomes among elderly patients with Alzheimer's disease and related dementias (ADRD) following major thoracic and gastrointestinal surgery. Methods A retrospective cohort study was used to identify patients who underwent coronary artery bypass grafting (CABG), abdominal aortic aneurysm (AAA) repair, pneumonectomy, pancreatectomy, and colectomy. Individuals were identified from the Medicare Standard Analytic Files and multivariable regression was utilized to assess the association of ADRD with textbook outcome (TO), expenditures, and discharge disposition. Results Among 1,175,010 Medicare beneficiaries, 19,406 (1.7%) patients had a preoperative diagnosis of ADRD (CABG: n = 1,643, 8.5%; AAA repair: n = 5,926, 30.5%; pneumonectomy: n = 590, 3.0%; pancreatectomy: n = 181, 0.9%; and colectomy: n = 11,066, 57.0%). After propensity score matching, patients with ADRD were less likely to achieve a TO (ADRD: 31.2% vs. no ADRD: 40.1%) or be discharged to home (ADRD: 26.7% vs. no ADRD: 46.2%) versus patients who did not have ADRD (both p 
ISSN:0364-2313
1432-2323
DOI:10.1002/wjs.12106