{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T15:18:51Z","timestamp":1770045531249,"version":"3.49.0"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,7,13]],"date-time":"2019-07-13T00:00:00Z","timestamp":1562976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG044424"],"award-info":[{"award-number":["R01AG044424"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To examine loss of community\u2010dwelling status 9 months after hospitalization for high\u2010acuity emergency general surgery (HA\u2010EGS) disease among older Americans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Retrospective analysis of claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>US communities with Medicare beneficiaries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Medicare beneficiaries age 65 years or older hospitalized urgently\/emergently between January 1, 2015, and March 31, 2015, with a principal diagnosis representing potential life or organ threat (necrotizing soft tissue infections, hernias with gangrene, ischemic enteritis, perforated viscus, toxic colitis or gastroenteritis, peritonitis, intra\u2010abdominal hemorrhage) and an operation of interest on hospital days 1 or 2 (N = 3319).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>\n                      Demographic characteristics (age, race, and sex), comorbidities, principal diagnosis, complications, and index hospitalization disposition (died; discharged to skilled nursing facility [SNF], long\u2010term acute care [LTAC], rehabilitation, hospice, home (with or without services), or acute care hospital; other) were measured. Survivors of index hospitalization were followed until December 31, 2015, on mortality and community\u2010dwelling status (SNF\/LTAC vs not). Descriptive statistics, Kaplan\u2010Meier plots, and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests were used to describe and compare the cohort based on disposition. A multivariable logistic regression model, adjusted for age, sex, comorbidities, complications, and discharge disposition, determined independent predictors of loss of community\u2010dwelling status at 9 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 2922 (88%) survived index hospitalization. Likelihood of discharge to home decreased with increasing age, baseline comorbidities, and in\u2010hospital complications. Overall, 418 (14.3%) HA\u2010EGS survivors died during the follow\u2010up period. Among those alive at 9 months, 10.3% were no longer community dwelling. Initial discharge disposition to any location other than home and three or more surgical complications during index hospitalization were independent predictors of residing in a SNF\/LTAC 9 months after surviving HA\u2010EGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Older Americans, known to prioritize living in the community, will experience substantial loss of independence due to HA\u2010EGS. Long\u2010term expectations after surviving HA\u2010EGS must be framed from the perspective of the outcomes that older patients value the most. Further research is needed to examine the quality\u2010of\u2010life burden of EGS survivorship prospectively.\n                      <jats:bold>J Am Geriatr Soc 67:2289\u20132297, 2019<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16046","type":"journal-article","created":{"date-parts":[[2019,7,13]],"date-time":"2019-07-13T11:29:45Z","timestamp":1563017385000},"page":"2289-2297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Loss of Community\u2010Dwelling Status Among Survivors of High\u2010Acuity Emergency General Surgery Disease"],"prefix":"10.1111","volume":"67","author":[{"given":"Jason W.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Surgery University of Louisville Louisville Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Knight 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