부산대학교 도서관

Keywords: co-management model; geriatric care; postoperative complications Abstract Background Older surgical patients have an increased risk for postoperative complications, driving up healthcare costs. We determined if postoperative co-management of older surgery patients is associated with postoperative outcomes and hospital costs. Methods Retrospective data were collected for patients â¥70years old undergoing colorectal surgery at a community teaching hospital. Patient outcomes were compared between those receiving postoperative surgery co-management care through the Optimization of Senior Care and Recovery (OSCAR) program and controls who received standard of care. Main outcome measures were postoperative complications and hospital charges, 30-day readmission rate, length of stay (LOS), and transfer to intensive care during hospitalization. Multivariable linear regression was used to model total charge and multivariable logistic regression to model complications, adjusted for multiple variables (e.g., age, sex, race, body mass index, Charlson Comorbidity Index [CCI], American Society of Anesthesiologists score, surgery duration). Results All 187 patients in the OSCAR and control groups had a similar mean CCI score of 2.7 (p = 0.95). Compared to the control group, OSCAR recipients experienced less postoperative delirium (17% vs. 8%; p= 0.05), cardiac arrhythmia (12% vs. 3%; p = 0.03), and clinical worsening requiring transfer to intensive care (20% vs. 6%; p Conclusions A co-management care approach after colorectal surgery in older patients improves outcomes and decreases costs, with the most benefit going to the oldest patients and those with higher comorbidity scores. Article Note: Matthew D. Vrees and Lynn McNicoll shared senior authorship. CAPTION(S): Table S1. OSCAR interventions (all performed in postoperative settings through geriatrics co-management). Byline: Sevdenur Cizginer, Eian G. Prohl, Joao Filipe G. Monteiro, Ferhat Yildiz, Richard N. Jones, Steven Schechter, Robert Patterson, Adam Klipfel, Mark Richard Katlic, Lori A. Daiello, Nadia Mujahid, Iva Neupane, William G. Cioffi, Maria Ducharme, Matthew D. Vrees, Lynn McNicoll