{"id":20550,"date":"2024-10-15T09:15:25","date_gmt":"2024-10-15T13:15:25","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=20550"},"modified":"2024-10-18T09:29:36","modified_gmt":"2024-10-18T13:29:36","slug":"primary-care-follow-up-improves-outcomes-in-older-adults-following-emergency-general-surgery-admission","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/primary-care-follow-up-improves-outcomes-in-older-adults-following-emergency-general-surgery-admission\/","title":{"rendered":"Primary care follow-up improves outcomes in older adults following emergency general surgery admission"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014\u00a0While preoperative optimization improves outcomes for older adults undergoing major elective surgery, no such optimization is possible in the emergent setting. Surgeons must identify postoperative interventions to improve outcomes among older emergency general surgery (EGS) patients. The objective of this cohort study was to examine the association between early follow-up with a primary care physician (PCP) and the risk of nursing home acceptance or death in the year following EGS admission among older adults.<\/p>\n<p><strong>Methods<\/strong> \u00a0\u2014 Using population-based administrative health data in Ontario, Canada (2006\u20132016), we followed all older adults (65 years or older) for 1 year after hospital admission for EGS conditions. A multivariable Cox model was used to identify the association between early postdischarge follow-up with a patient&rsquo;s PCP and the time to nursing home acceptance or death while adjusting for confounders.<\/p>\n<p><strong>Results<\/strong> \u2014\u00a0Among 76,568 older EGS patients, 32,087 (41.9%) were seen by their usual PCP within 14 days of discharge, and 9,571 (12.5%) were accepted to a nursing home or died within 1 year. Primary care physician follow-up was associated with a 13% reduced risk of nursing home acceptance or death compared with no follow-up (hazard ratio 0.87; 95% confidence interval 0.84\u20130.91). This effect was consistent across age and frailty strata, patients managed operatively and nonoperatively, and patients who had both high and low baseline continuity of care with their PCP.<\/p>\n<p><strong>Conclusion<\/strong> \u2014\u00a0Early follow-up with a familiar PCP was associated with a reduced risk of nursing home acceptance or death among older adults following EGS admission. Structures and processes of care are needed to ensure that such follow-up is routinely arranged at discharge.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014\u00a0While preoperative optimization improves outcomes for older adults undergoing major elective surgery, no such optimization is possible in the emergent setting. Surgeons must identify postoperative interventions to improve outcomes among older emergency general surgery (EGS) patients. The objective of this cohort study was to examine the association between early follow-up with a primary care [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[62,17,28],"migration-helper-qa-sample-set":[],"class_list":["post-20550","journal_article","type-journal_article","status-publish","hentry","topic-health-services-research","topic-older-people","topic-primary-care"],"acf":{"citation":"Guttman MP, Tillmann BW, Nathens AB, Bronskill SE, Saskin R, Jaakkimainen L, Huang A, Haas B.<em> J\u00a0<span class=\"highlight\">Trauma<\/span>\u00a0<span class=\"highlight\">Acute<\/span>\u00a0<span class=\"highlight\">Care<\/span> Surg<\/em>. 2024; Oct 15 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1097\/TA.0000000000004464","ices_scientist":[1303,1159,1360,1283,1265],"site":[6733],"research_program":[6745],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Primary care follow-up improves outcomes in older adults following emergency general surgery admission<\/title>\n<meta name=\"description\" content=\"Background \u2014\u00a0While preoperative optimization improves outcomes for older adults undergoing major elective surgery, no such optimization is possible in the\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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