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May 9, 2014Journal of the American College of SurgeonsOpen Access

The Importance of the First Complication: Understanding Failure to Rescue after Emergent Surgery in the Elderly

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Why the study?

Does older age (≥75 years) increase the rate of failure to rescue after complications in patients undergoing emergent general or vascular surgery?

Population

23,217 patients undergoing emergent general or vascular surgery procedures at 41 hospitals within the…

Comparison

Age ≥75 years (elderly) vs Age <75 years (younger patients)

Design

Cohort

Follow-up

30-day

Authors

KSKyle H. SheetzUniversity of MichiganRKRobert KrellUniformed Services University of the Health SciencesMEMichael J. EnglesbeUniversity of North Carolina at Chapel Hill

Discussion

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Implication

May support enhanced surveillance after complications in elderly emergent surgery patients; leaves open whether age-specific interventions improve rescue rates.

Structured PICO

Does older age (≥75 years) increase the rate of failure to rescue after complications in patients undergoing emergent general or vascular surgery?

P
Population
23,217 patients undergoing emergent general or vascular surgery procedures at 41 hospitals within the Michigan Surgical Quality Collaborative between 2007 and 2012
I
Intervention
Age ≥75 years (elderly)
C
Comparator
Age <75 years (younger patients)
O
Outcome
Failure to rescue rates after specific complications (infectious, pulmonary, cardiovascular)hard clinical

Elderly patients undergoing emergent surgery have significantly higher failure to rescue rates after infectious and pulmonary complications compared to younger patients, highlighting a target for quality improvement.

Cite This Study

Sheetz et al. (2014) studied this question.

synapsesocial.com/papers/6a7cfb2e13f8126410a1ea00https://doi.org/10.1016/j.jamcollsurg.2014.02.035
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Surgical Outcomes for Patients Aged 80 and Older: Morbidity and Mortality from Major Noncardiac Surgery2005 · 638 citations
  2. 2Reliability Adjustment for Reporting Hospital Outcomes With Surgery2012 · 169 citations
  3. 3Improving Mortality Following Emergent Surgery in Older Patients Requires Focus on Complication Rescue2013 · 89 citations
  4. 4Myocardial Injury After Noncardiac Surgery and its Association With Short-Term Mortality2013 · 337 citations
  5. 5Failure-to-Pursue Rescue2012 · 101 citations