39DO OLDER SURGICAL PATIENTS WHO UNDERGO EMERGENCY OPERATION HAVE HIGHER MORTALITY AND LONGER LENGTH OF HOSPITALISATION COMPARED TO THOSE MANAGED CONSERVATIVELY?
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".