Abstract：
BACKGROUND:Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults. METHODS:Based on a standardized definition of EGS, patients in the 2007 to 2011 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample were queried for primary EGS diagnoses. Included patients were categorized into older (≥80 years) vs younger (<80 years) adults based on a marked increase in mortality around aged 80 years. Using propensity scores, risk-adjusted differences in major morbidity, mortality, length of stay (LOS), and cost were compared. RESULTS:Of 3,707,465 included patients, 17.2% (n = 637,588) were ≥80 years. Relative to younger adults, older patients most frequently presented for gastrointestinal-bleeding (odds ratio [95% confidence intervals]: 2.81 [2.79 to 2.82]) and gastrostomy care (2.46 [2.39 to 2.53]). Despite higher odds of mortality (1.67 [1.63 to 1.69]), older adults exhibited lower risk-adjusted odds of morbidity (.87 [.86 to .88]), shorter LOS (4.50 vs 5.14 days), and lower total hospital costs ($10,700 vs $12,500). CONCLUSIONS:Octogenarian and/or nonagenarian patients present differently than younger adults. Reductions in complications, LOS, and cost among surviving older adults allude to a "survivorship tendency" to never give up, despite collectively higher mortality risk.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Shah AA,Zafar SN,Kodadek LM,Zogg CK,Chapital AB,Iqbal A,Greene WR,Cornwell EE 3rd,Havens J,Nitzschke S,Cooper Z,Salim A,Haider AHdoi
10.1016/j.amjsurg.2016.01.021subject
Has Abstractpub_date
2016-08-01 00:00:00pages
211-220.e3issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(16)30117-9journal_volume
212pub_type
杂志文章abstract：:Massive doses of methylprednisolone were given to dogs prior to severe, lethal, hemorrhagic shock. An untreated group of dogs subjected to hemorrhagic shock served as controls. No persistent significant differences were seen in cardiac output, mean arterial blood pressure, superior mesenteric artery flow, and survival...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90394-3
更新日期：1975-09-01 00:00:00
abstract：:The human papillomavirus (HPV) has been shown to be associated with neoplasms of the human colon using immunohistochemistry and in situ hybridization. We now report our use of the polymerase chain reaction and Southern blotting to investigate that same association. We selected 38 carcinomas, 21 adenomas, and 24 normal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80690-7
更新日期：1993-12-01 00:00:00
abstract：BACKGROUND:Medical schools are undergoing major curricular reform, partly in attempts to increase the number of graduates pursuing careers in the generalist disciplines. These reforms have often resulted in a shortening of the surgery clerkship, decreasing students' experiences in several domains important to the gener...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)89595-5
更新日期：1997-03-01 00:00:00
abstract：BACKGROUND:Bariatric patients may not always obtain long-term care by their primary surgeon. Our aim was to evaluate weight loss outcomes in patients who had surgery elsewhere. METHODS:We conducted a retrospective analysis. Postreferral management included nonsurgical, revision, or conversion. Primary outcomes were pe...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.04.025
更新日期：2016-07-01 00:00:00
abstract：:The influence of preoperative liver scans and liver function tests on surgical decision-making was analyzed in 196 patients who underwent surgical therapy for colorectal cancer. One hundred and thirteen patients who had preoperative liver scans were compared with 83 patients who did not. No statistically significant d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90101-7
更新日期：1986-04-01 00:00:00
abstract：:Several recent reviews have suggested that aggressive surgical intervention can reduce morbidity and mortality associated with intra-abdominal crises in AIDS patients. We reviewed our experience with 57 AIDS patients with 63 emergent laparotomies performed at 4 hospitals affiliated with the University of California in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80194-1
更新日期：1994-09-01 00:00:00
abstract：:A patient with acute amebic dilatation of the colon and multiple intrahepatic abscesses was successfully treated by a combination of medical and surgical therapy. Creation of a loop ileostomy and blow-hole colostomy facilitated complete healing of the colon. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90317-7
更新日期：1980-03-01 00:00:00
abstract：:Total pancreatectomy with islet autotransplantation is a promising treatment for refractory chronic pancreatitis. We analyzed postoperative complications in 83 TPIAT patients and their impact on islet graft function. We examined patient demographics, preoperative risk factors, intraoperative variables, and 30- and 90-...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.04.007
更新日期：2020-01-01 00:00:00
abstract：:Distal embolization of fragmented laminated thrombus and atheroma producing peripheral ischemia or gangrene is an underemphasized complication of arterial reconstruction. A set of techniques has been developed to minimize this important complication. To assess their effectiveness, the incidence of distal embolism in p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90293-9
更新日期：1979-12-01 00:00:00
abstract：BACKGROUND:Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. METHODS:All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). RESULTS:A total of 1,270 (8.5%) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.023
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to analyze the influence of age on both the risk of hepatectomy and the prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Patients undergoing an initial hepatectomy for HCC were classified into 2 age groups: 75 years or over (n = 113) and less than 75 years (n ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.05.026
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:The ideal treatment algorithm for suspected choledocholithiasis is not yet well defined. Imaging options include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and intraoperative cholangiogram (IOC). MRCP is diagnostic, while the other two modalitie...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.10.025
更新日期：2017-08-01 00:00:00
abstract：:We found clinical phlebitis in 57 of 88 patients with peripheral hyperalimentation (65%). To determine if this was a problem common to all intravenous fluid therapy at our hospital, we performed a point-prevalence study. The prevalence of phlebitis in nonhyperalimentation intravenous patients was 18% (84 of 456 patien...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(05)80266-1
更新日期：1990-02-01 00:00:00
abstract：BACKGROUND:Cholangiocarcinoma develops in 5% to 15% of patients with choledochal cysts, sclerosing cholangitis, and intrahepatic stones. The detection of cholangiocarcinoma in patients with premalignant biliary conditions has been difficult. Serum levels of carcinoembryonic antigen (CEA) have been neither sensitive nor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(99)80090-7
更新日期：1996-01-01 00:00:00
abstract：:We studied 48 patients with laryngeal or hypopharyngeal primary tumors with DNA flow cytometry. Twenty-four of the tumors were glottic, 18 were supraglottic, and 6 were from the pyriform sinus. Patients were followed for a minimum of 12 months, with a mean follow-up of 23 months. Twenty-three of the 48 primary tumors ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90311-9
更新日期：1986-10-01 00:00:00
abstract：:We compared the prevalence of stroke and death in 133 patients aged 75 and older in whom 170 carotid endarterectomies were performed with that in 501 patients less than age 75 in whom 640 carotid endarterectomies were performed. There were three strokes (2%) in patients aged 75 and older and nine strokes (1%) in young...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80753-6
更新日期：1990-12-01 00:00:00
abstract：:Five patients with infected abdominal aortoiliac aneurysms were treated. The diagnosis was made preoperatively based upon fever, leukocytosis, positive blood culture findings, and presence of an aneurysm in all five patients. Two patients had salmonella species, two had staphylococcus species, and one had bacteroides ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80137-5
更新日期：1988-05-01 00:00:00
abstract：:The records of 125 consecutive patients with unresectable pancreatic cancer treated between 1958 and 1979 were evaluated to determine the benefit or morbidity of gastroenterostomy performed on a routine basis. One hundred three patients had no evidence of gastric outlet obstruction from tumor extension as determined a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90203-4
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND:In recent years, increasingly accessible and novel genetic technologies have spurred keen interest in the application of cancer genetics in predicting prognosis and response to treatment. In particular, investigators have eagerly sought to establish and validate genetic signatures that might improve the iden...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.06.019
更新日期：2016-10-01 00:00:00
abstract：:Between 1960 and 1990, a total of 998 patients were treated at the Sydney Melanoma Unit for cutaneous melanoma of the head and neck. There were 595 male and 403 female patients, with a median age of 53 years. The most common primary lesion site was the face (47%), followed by the neck (29%), scalp (14%), and ear (10%)...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90138-4
更新日期：1991-10-01 00:00:00
abstract：:Familial visceral myopathy is a form of chronic intestinal pseudoobstruction in which fibrosis of the smooth muscle of the alimentary tract causes protean symptoms of disordered visceral motility. Based on our 8 year observation of six members of one family with familial visceral myopathy and review of the few well-do...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90017-0
更新日期：1985-07-01 00:00:00
abstract：BACKGROUND:Procedural teaching and the ability to detect and correct errors are important components of surgical education. This study evaluates whether review of an instructional video will improve residents' ability to detect errors. We hypothesized that clinical experience and confidence do not correlate with abilit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.08.026
更新日期：2017-06-01 00:00:00
abstract：BACKGROUND:Predictors of weight loss (WL) or weight regain (WR) after Roux-en-Y gastric bypass (RYGBP) are not established. The aim of this study was to analyze the usefulness of some baseline peptides (leptin, insulin, and ghrelin) as biomarkers of WL and WR in morbid obese patients after RYGBP at long term. METHODS:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.040
更新日期：2015-08-01 00:00:00
abstract：BACKGROUND:The changing environment in academic medical centers has had a major effect on the recruitment and the demographic characteristics of leadership positions in academic surgery. Categorization of "cultures" from the business model has been extrapolated into the academic surgical model. METHODS:The types of cu...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/s0002-9610(02)00814-0
更新日期：2002-04-01 00:00:00
abstract：PURPOSE:During general surgery (GS) training, residents are expected to accurately interpret radiologic images. Objective evidence evaluating residents' ability to provide accurate interpretation of imaging studies is currently lacking. METHODS:A 30-item web-based test was developed using images from different radiolo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.11.029
更新日期：2017-03-01 00:00:00
abstract：BACKGROUND:Wound healing and chronic wounds are serious public health issues. While wounds heal, cellular stores of antioxidants are depleted. d-ribose-l-cysteine (DRLC) is a precursor to the antioxidant glutathione. The effect of oral supplementation with DRLC on wound healing was studied in rats. METHODS:A rodent mo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.11.014
更新日期：2015-07-01 00:00:00
abstract：:An improved technic for total thyroidectomy, utilizing magnification, is described. A method of preservation of the parathyroid glands with intact blood supply has been developed. The completeness of total thyroidectomy has been confirmed in 91 per cent of patients studied by postoperative radioactive iodine scan. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90472-9
更新日期：1975-10-01 00:00:00
abstract：BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：:Mesenteric vascular disease continues to be associated with an extremely high mortality. It is not necessarily a disease of old age: 20 of the 75 patients in our series were less than 60 years of age. In retrospect, earlier diagnosis and a more aggressive approach could have improved the survival rate of 17.3 percent....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90251-2
更新日期：1980-02-01 00:00:00
abstract：:Schatzki's ring is a distinct anatomical entity associated with hiatal hernia; however, its significance is unclear. Thirty-two patients with a radiologically demonstrated Schatzki's ring were compared with 32 patients with hiatal hernia and no Schatzki's ring. Schatzki's ring was confirmed on endoscopy in 59 percent ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90193-1
更新日期：1989-12-01 00:00:00
