First do no harm: Predicting futility of intervention in geriatric emergency general surgery

Emergent surgical conditions are common in geriatric patients, often necessitating major operative procedures on frail patients. Understanding risk profiles is crucial for decision-making and establishing goals of care. We queried NSQIP 2015–2019 for patients ≥65 years undergoing open abdominal surg...

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Bibliographic Details
Published in:The American journal of surgery 2024-10, Vol.236, p.115841, Article 115841
Main Authors: Lagazzi, Emanuele, Yi, Alisha, Nzenwa, Ikemsinachi C., Panossian, Vahe S., Rafaqat, Wardah, Abiad, May, Hoekman, Anne H., Arnold, Suzanne, Luckhurst, Casey M., Parks, Jonathan J., Velmahos, George C., Kaafarani, Haytham M.A., Hwabejire, John O.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal surgery
Ascites
Decision making
Dialysis
Emergency general surgery
Emergency procedures
Ethnicity
Frailty
Futility
Geriatric surgery
Geriatrics
Goals of care
Hemodialysis
Intestine
Kidneys
Laparotomy
Medical prognosis
Mortality
Older adults
Older people
Patients
Postoperative period
Regression analysis
Risk factors
Sepsis
Septic shock
Small intestine
Surgeons
Surgery
Ulcers
Variables
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Summary:Emergent surgical conditions are common in geriatric patients, often necessitating major operative procedures on frail patients. Understanding risk profiles is crucial for decision-making and establishing goals of care. We queried NSQIP 2015–2019 for patients ≥65 years undergoing open abdominal surgery for emergency general surgery conditions. Logistic regression was used to identify 30-day mortality predictors. Of 41,029 patients, 5589 (13.6 ​%) died within 30 days of admission. The highest predictors of mortality were ASA status 5 (aOR 9.7, 95 ​% CI,3.5–26.8, p ​
ISSN:0002-9610
1879-1883
1879-1883
DOI:10.1016/j.amjsurg.2024.115841