2024
National Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults
Wang Y, Leo-Summers L, Vander Wyk B, Davis-Plourde K, Gill T, Becher R. National Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults. JAMA Network Open 2024, 7: e240028. PMID: 38416499, PMCID: PMC10902728, DOI: 10.1001/jamanetworkopen.2024.0028.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesFee-for-serviceMedicare Advantage beneficiariesHospital readmissionUS residentsNational Health and Aging Trends Study dataCommunity-living older adultsProspective longitudinal cohort studyCommunity-living participantsRate of hospital readmissionLikelihood of hospital readmissionPopulation-based estimatesNationally representative estimatesSex-adjusted modelsCommunity-livingData linkageGeriatric conditionsMedicaid ServicesOlder personsOlder adultsMain OutcomesNational estimatesRepresentative estimatesData analysisCohort study
2023
Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons
Gill T, Han L, Feder S, Gahbauer E, Leo-Summers L, Becher R. Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2023, 279: 65-70. PMID: 37389893, PMCID: PMC10761592, DOI: 10.1097/sla.0000000000005984.Peer-Reviewed Original ResearchConceptsMajor surgeryDistressing symptomsElective surgeryFunctional outcomeOlder personsCommunity-living older personsMultiple distressing symptomsSocioeconomic disadvantageCommunity-living personsTiming of surgerySerious health eventsNumber of disabilitiesSurgerySignificant associationSymptomsHealth eventsRate ratioPotential targetDisabilityUnit increaseDeleterious effectsOutcomesPersonsMultimorbidityAdmission
2022
Population-Based Estimates of 1-Year Mortality After Major Surgery Among Community-Living Older US Adults
Gill TM, Vander Wyk B, Leo-Summers L, Murphy TE, Becher RD. Population-Based Estimates of 1-Year Mortality After Major Surgery Among Community-Living Older US Adults. JAMA Surgery 2022, 157: e225155. PMID: 36260323, PMCID: PMC9582971, DOI: 10.1001/jamasurg.2022.5155.Peer-Reviewed Original ResearchConceptsPopulation-based estimatesMajor surgeryMean survival timeOlder US adultsProbable dementiaUS adultsSurvival timeSex-adjusted hazard ratioProspective longitudinal cohort studyCommunity-living older adultsLongitudinal cohort studyPotential prognostic valueService Medicare beneficiariesNon-Hispanic blacksNon-Hispanic whitesAging Trends StudyGeriatric characteristicsCohort studyGeriatric surgeryHazard ratioNonelective surgeryElective surgeryGeriatric conditionsPrognostic valueMean ageFactors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons
Gill TM, Becher RD, Murphy TE, Gahbauer EA, Leo-Summers L, Han L. Factors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2022, 278: e13-e19. PMID: 35837967, PMCID: PMC9840715, DOI: 10.1097/sla.0000000000005528.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overHospitalizationHospitalsHumansPatient DischargeQuality of LifeRisk FactorsConceptsHealth care facilitiesMajor surgeryAge 85 yearsCare facilitiesOlder personsRisk factorsNumber of daysLower peak expiratory flowCommunity-living older personsShort Physical Performance BatteryIndependent risk factorCommunity-living personsPhysical Performance BatteryPeak expiratory flowCandidate risk factorsQuality of lifeHospital dischargeMultivariable analysisExpiratory flowMedian numberPerformance BatteryMusculoskeletal surgerySurgeryMean differenceHospitalGeriatric vulnerability and the burden of disability after major surgery
Gill TM, Murphy TE, Gahbauer EA, Leo‐Summers L, Becher RD. Geriatric vulnerability and the burden of disability after major surgery. Journal Of The American Geriatrics Society 2022, 70: 1471-1480. PMID: 35199332, PMCID: PMC9106872, DOI: 10.1111/jgs.17693.Peer-Reviewed Original ResearchConceptsBurden of disabilityMajor surgeryGeriatric vulnerabilitiesHospital dischargeElective surgeryFunctional outcomeLong-term functional outcomeStrong epidemiologic evidenceCommunity-living personsPoor functional outcomeNon-elective surgeryProspective longitudinal studyAdditional vulnerability factorVulnerability factorsMultivariable analysisEpidemiologic evidenceSurgery increasesBlack raceDisability burdenFemale sexMore disabilityAge 85Hispanic ethnicitySurgeryOlder persons
2021
The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States
Becher RD, Vander Wyk B, Leo-Summers L, Desai MM, Gill TM. The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States. Annals Of Surgery 2021, 277: 87-92. PMID: 34261884, PMCID: PMC8758792, DOI: 10.1097/sla.0000000000005077.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDementiaHumansIncidenceLongitudinal StudiesMedicareProspective StudiesUnited StatesConceptsMajor surgeryOlder personsCumulative riskNational HealthCommunity-living older personsHigh-quality surgical careNon-frail groupPopulation-based incidenceService Medicare beneficiariesMedicaid Services dataCumulative risk estimatesProspective longitudinal studyUnited States agesAging Trends StudyGeriatric characteristicsRepresentative incidenceFrail groupAdjusted incidenceGeriatric populationProbable dementiaSurgical carePersons 85Medicare beneficiariesSurgeryVulnerable subgroups
2020
Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Becher RD. Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons. Annals Of Surgery 2020, 273: 834-841. PMID: 33074902, PMCID: PMC8370041, DOI: 10.1097/sla.0000000000004438.Peer-Reviewed Original ResearchConceptsMajor surgeryED visitsRestricted activityFunctional statusFunctional declineOlder personsCommunity-living older personsAdjusted hazard ratioAdverse functional outcomesCommunity-living personsEmergency department visitsTraditional risk factorsCorresponding odds ratiosFunctional effectsIllness/injuryHazard ratioDepartment visitsFunctional recoveryFunctional outcomeRisk factorsOdds ratioHospitalizationSurgeryInjuryVisitsHospital Variation in Geriatric Surgical Safety for Emergency Operation
Becher RD, Sukumar N, DeWane MP, Stolar MJ, Gill TM, Schuster KM, Maung AA, Zogg CK, Davis KA. Hospital Variation in Geriatric Surgical Safety for Emergency Operation. Journal Of The American College Of Surgeons 2020, 230: 966-973.e10. PMID: 32032720, PMCID: PMC7409563, DOI: 10.1016/j.jamcollsurg.2019.10.018.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioHospital-level characteristicsGeneral surgery operationsGeriatric patientsEmergency operationHospital variationEmergency general surgery operationsMean standardized mortality ratioCalifornia State Inpatient DatabaseHospital-based mortalitySignificant hospital variationPatients 65 yearsSubstantial excess mortalitySurgery operationsState Inpatient DatabasesMixed effects logistic regression modelsCommon general surgery operationsLow-mortality outliersLogistic regression modelsPostoperative mortalityHospital deathOlder patientsInpatient DatabaseMortality outcomesNonelective operations
2019
Top-tier emergency general surgery hospitals: Good at one operation, good at them all.
DeWane MP, Sukumar N, Stolar MJ, Gill TM, Maung AA, Schuster KM, Davis KA, Becher RD. Top-tier emergency general surgery hospitals: Good at one operation, good at them all. Journal Of Trauma And Acute Care Surgery 2019, 87: 289-296. PMID: 31349347, PMCID: PMC6771423, DOI: 10.1097/ta.0000000000002367.Peer-Reviewed Original ResearchConceptsRisk-adjusted mortalityEGS hospitalsHospital risk-adjusted mortalityOperation typeEGS operationsCalifornia State Inpatient DatabaseGeneral surgery hospitalsHospital-level factorsAcute care hospitalsState Inpatient DatabasesAmerican Hospital Association databasePoor-performing hospitalsSystems of careLow-risk operationAssessment of mortalityAdult patientsCare hospitalSurgery HospitalInpatient DatabaseHospital characteristicsMultinomial logistic regressionMortality rateHospitalLevel IIIZ-scoreHospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients
Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Becher RM, Maung AA, Schuster KM, Davis KA. Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients. Journal Of The American College Of Surgeons 2019, 228: 910-923. PMID: 31005629, PMCID: PMC6582986, DOI: 10.1016/j.jamcollsurg.2019.02.053.Peer-Reviewed Original ResearchConceptsHospital operative volumeGeneral surgery operationsGeriatric patientsOperative volumeEmergency operationHospital volumeProbability of survivalEmergency general surgery operationsCalifornia State Inpatient DatabaseRetrospective cohort studySurgery operationsState Inpatient DatabasesHigher operative volumesAverage mortality riskOlder patientsCohort studyInpatient DatabaseGeriatric populationSurgical careSurgical qualityAmerican CollegeMortality riskOptimizing outcomesStandardized increasePatients
2018
Functional Trajectories Before and After Major Surgery in Older Adults
Stabenau HF, Becher RD, Gahbauer EA, Leo-Summers L, Allore HG, Gill TM. Functional Trajectories Before and After Major Surgery in Older Adults. Annals Of Surgery 2018, 268: 911-917. PMID: 29356710, PMCID: PMC6521949, DOI: 10.1097/sla.0000000000002659.Peer-Reviewed Original ResearchConceptsMajor surgeryNonelective surgeryFunctional trajectoriesSevere disabilityOlder adultsCourse of disabilityFirst major surgeryPersons 70 yearsProspective cohort studyCohort studyFunctional prognosisModerate disabilityPartial improvementSurgeryPremorbid functionOlder personsStudy periodAnalytic sampleLittle improvementRapid improvementTrajectory groupsMild disabilityMost participantsDisabilityGradual improvement