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Examining disparities among older multimorbid emergency general surgery patients: An observational study of Medicare beneficiaries.
Roberts, Sanford E; Rosen, Claire B; Wirtalla, Christopher J; Finn, Caitlin B; Kaufman, Elinore J; Reilly, Patrick M; Syvyk, Solomiya; McHugh, Matthew D; Kelz, Rachel R.
Afiliação
  • Roberts SE; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: Sanford.roberts@pennmedicine.upenn.edu.
  • Rosen CB; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Wirtalla CJ; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Finn CB; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Kaufman EJ; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Reilly PM; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Syvyk S; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • McHugh MD; Center for Health Outcomes & Policy Research, University of Pennsylvania School of Nursing, University of Pennsylvania, USA.
  • Kelz RR; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA; Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Am J Surg ; 225(6): 1074-1080, 2023 06.
Article em En | MEDLINE | ID: mdl-36473737
BACKGROUND: Qualifying comorbidity sets (QCS) are tools used to identify multimorbid patients at increased surgical risk. It is unknown how the QCS framework for multimorbidity affects surgical risk in different racial groups. METHODS: This retrospective cohort study included Medicare patients age ≥65.5 who underwent an emergency general surgery operation from 2015 to 2018. Our exposure was race and multimorbidity, included in our model as an interaction term. The primary outcome of the study was 30-day mortality. Secondary outcomes included routine discharge, 30-day readmission, length of stay, and complications. RESULTS: In total, 163,148 patients who underwent and operation were included in this study. Of these, 13,852 (8.5%, p < 0.001) were Black, and 149,296 (91.5%, p < 0.001) were White. Black multimorbid patients had no significant differences in 30-day mortality, routine discharge or 30-day readmission when compared to White multimorbid patients after risk-adjustment. Black multimorbid patients had significantly lower odds of complications (OR 0.89, p = 0.014) compared to White multimorbid patients. CONCLUSIONS: Our study of universally insured patients highlights the critical role of pre-operative health status and its association with surgical outcomes.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Medicare / Multimorbidade Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Aged / Humans País como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Medicare / Multimorbidade Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Aged / Humans País como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article