39DO OLDER SURGICAL PATIENTS WHO UNDERGO EMERGENCY OPERATION HAVE HIGHER MORTALITY AND LONGER LENGTH OF HOSPITALISATION COMPARED TO THOSE MANAGED CONSERVATIVELY?
Notice bibliographique
Résumé
It is unclear whether older surgical patients who undergo emergency operation have higher mortality or longer length of hospitalisation compared to those managed conservatively. We set out to assess the prevalence of operations during emergency surgical admission of older people (≥65 years) and its association with mortality at 30 days post-admission and length of hospitalisation. We analysed data from the Older Persons Surgical Outcomes Collaboration (www.OPSOC.eu) (2013 and 2014 data) to calculate the prevalence of emergency operations in older acute surgical admissions. The effect of operation on study outcomes was examined using multivariate logistic regression adjusting for age, gender, polypharmacy, haemoglobin, albumin, and frailty (assessed using the validated 7-point Canadian Study of Health and Ageing clinical frailty score). Data were collected for 727 patients [mean age (standard deviation) = 77.1 (8.2) years, 54% female]. Of them, 185 (25%) underwent emergency operation. Patients that received an operation were younger than those who did not [76(7.7) vs. 78(8.4) years; P < 0.001]. The prevalence of operation was greater in males (30.2% males (receiving operation) vs. 23.5% males (receiving conservative management); P = 0.006). There was no difference between operated and non-operated patients for other characteristics under examination (frailty category, polypharmacy, and low serum albumin, or haemoglobin levels). Multivariate analyses showed no association between operation and mortality at 30 days [adjusted odds ratio (AOR) = 0.40 (95% CI 0.13–1.25; P = 0.116)]. Operation was associated with significantly increased odds for longer than median length of hospital stay [AOR = 5.98 (95% CI 3.97–8.99; P < 0.001)]. The main limitation of this study was data were not collected on diagnoses of the patients, whether surgeries were indicated, or if it was decided to manage patients conservatively due to frailty or multi- morbidity. A quarter patients from this cohort had an emergency operation during their acute surgical admission in the UK setting. Operation was associated with longer length of hospitalisation but no association with 30 days mortality was demonstrated. Whether there is potential to improve the length of hospitalisation outcome in this patient population through comprehensive geriatric assessment needs to be evaluated.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».