Procedure risk is more strongly associated with outcomes in older patients undergoing emergency general surgery than assessing frailty, according to a study published online April 25 in the Journal of the American College of Surgeons.
Bishoy Zakhary, M.P.H., from Riverside University Health System in Moreno Valley, California, and colleagues examined the association between procedure risk and outcomes in 59,633 older emergency general surgery patients (older than 65 years of age; 2018 to 2020).
The researchers found that frailty and procedure risk were associated with increased mortality, complications, failure to rescue, and readmissions. Compared with stratification by frailty alone, differences in outcomes were greater when patients were stratified according to procedure risk. Procedure risk had a stronger association with relevant outcomes in elderly emergency general surgery patients compared with frailty.
“What we also learned in this study is that a very significant number of elderly patients are coming to the emergency room for a major operation, urgently. And the reason is because elderly patients may not seek surgical care early on, and surgeons often shy away from solving the problems electively,” coauthor Raul Coimbra, M.D., Ph.D., also from the Riverside University Health System, said in a statement. “The problem is that diseases don’t disappear. They stay and progress and advance until these patients end up in the emergency department requiring an emergency operation.”
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