{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:04:23Z","timestamp":1769202263507,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Comprehensive studies on priority areas for improving geriatric surgery outcomes, inclusive of geriatric\u2010pertinent data, are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The ACS NSQIP geriatric database (2014\u20132018) was used to abstract older adults (\u226565\u00a0years) undergoing inpatient general surgery procedures. Thirty\u2010day complication, functional decline, and mortality rates were analyzed, with a focus on two geriatric\u2010pertinent complications: delirium and new\/worsening pressure ulcers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 9062 patients; 41.9% were \u226575\u00a0years. Mean age was 73.9\u00a0years. The majority of patients were female (54.0%), White (77.7%), and had independent functional status before surgery (94.0%). Overall 30\u2010day complication, functional decline, and mortality rates were 33.6%, 34.5%, and 3.5%, respectively; failure to the rescue rate was 9.7%. Including geriatric\u2010pertinent complications increased the overall complication rate by 20.4%. Delirium emerged as the leading complication (11.9%), followed by bleeding (11.1%), and wound\u2010related complications (10.1%); these three accounted for 53.7% of complications. Delirium and pressure ulcers were associated with a &gt;50% rate of postoperative functional decline (52.0% and 71.4%, respectively); pressure ulcers were also notable for a 25.5% failure to the rescue rate. Both were also among complications most likely to occur following the 3 most common procedures (colorectal surgery, pancreatic resections, and exploratory laparotomy), which overall accounted for approximately 79.6% of complications, 73.4% of patients experiencing functional decline, and 82.3% of mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Delirium is the leading complication among older adults undergoing inpatient surgery. Overall, a small number of complications and procedure groups account for most surgical morbidity and mortality among older adults and thus constitute priority areas for outcomes improvement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12331","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T03:38:01Z","timestamp":1727494681000},"page":"2646-2657","source":"Crossref","is-referenced-by-count":1,"title":["Priority areas for outcomes improvement among older adults undergoing inpatient general surgery inclusive of geriatric\u2010pertinent complications"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9358-3019","authenticated-orcid":false,"given":"Hadiza S.","family":"Kazaure","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology Department of Surgery Duke University  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly S.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System Geriatric Research and Clinical Center  Durham North Carolina USA"},{"name":"Division of Geriatrics Department of Medicine Center for the Study of Aging and Human Development Center for Palliative Care Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronnie","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandhya","family":"Lagoo\u2010Deenadayalan","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Department of Surgery Duke University  Durham North Carolina USA"},{"name":"Durham VA Health Care System Geriatric Research and Clinical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]","author":"McDermott K. 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