ArticleAnnals of surgery2025
Frailty and Survival for Diagnoses Feasibly Managed Operatively or Nonoperatively.
Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Prediction of Cardiopulmonary Resuscitation Outcomes for Arrest in Surgical Settings.JAMA network open · 2025Article
Corrections and comments
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Authors and funding
27 authors.
Funding
Abstract
objectiveCompare outcomes, stratified by frailty, of patients with eight common conditions with plausible operative and nonoperative management strategies. SUMMARY BACKGROUND DATA: A surgical pause, evaluating potential adverse outcomes among frail patients, improves postoperative outcomes; however, the outcomes among patients opting for nonoperative management are unknown.
methodsIn an observational cohort study across a multi-hospital healthcare system including adults presenting to outpatient surgical clinics (2016-2023) for evaluation of eight conditions feasibly managed operatively or nonoperatively as defined by modified Delphi consensus. In a landmarked analysis, we compared 2-year survival by management strategies across frailty categories (robust, normal, frail, very frail) as defined by the Risk Analysis Index (RAI). Secondarily we compared 365-day hospital free days (HFD-365), postoperative length of stay, and discharge disposition.
resultsAmong 49,169 patients (mean±SD age, 60.4±14.6 y; 54.6% female), operative management was associated with lower observed and adjusted mortality (1.3% vs 2.5%; aHR=0.55 [95% CI, 0.47-0.66], P<0.0001) overall and among all frailty categories expect the very frail (8.1% vs 12.1%, P=0.1). Additionally, operative management was associated with fewer HFD-365 again overall which was specifically prominent among the very frail (median 365 [IQR, 358-365] vs 361 days [IQR, 357-363], P<0.0001). Postoperatively, frailty portended more protracted recoveries with greater postoperative lengths of stay (1.7±2.6 vs 1.2±2.1) days, P<0.0001) and fewer discharges home (370 [85.1%] vs 5,087 [91.8%], P<0.0001; odds ratio=2.0 [95%CI 1.5-2.6]).
conclusionsConsidering the protracted postoperative recovery of very frail patients, nonoperative management might be the preferred treatment option for those presenting with these eight clinical conditions.
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