{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T01:19:50Z","timestamp":1777339190335,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG067507"],"award-info":[{"award-number":["R01AG067507"]}],"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":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgery is common among patients living with dementia, and understanding outcomes may help decision\u2010making. We compared patients' and utilization outcomes after high\u2010risk surgery among patients with and without dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective national cohort study, we compared outcomes of Medicare fee\u2010for\u2010service beneficiaries 66\u2009years or older who underwent high\u2010risk inpatient surgery (i.e., with an inpatient mortality of at least 1%) from January 1, 2017 to September 30, 2018. We examined 90\u2010 and 30\u2010day all\u2010cause mortality, major complications, discharge to a higher level of care, intensive end\u2010of\u2010life interventions, and prolonged skilled nursing facility (SNF) stay. We used generalized estimating equations regression modeling and competing risks analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 19,998,187 beneficiaries, we identified 859,570 who had fee\u2010for\u2010service coverage and were 66\u2009years or older at the time of a high\u2010risk surgery. Of these, 124,822 (14.5%) had a diagnosis of dementia. Female sex accounted for 81,252 (65.1%) of the dementia cohort. Four of five of the most common procedures were related to femur fracture and cardiac surgery in the dementia and non\u2010dementia cohorts. Ninety\u2010day mortality was worse among patients with dementia: 22.8% versus 9.3% (adjusted odds ratio [aOR] 1.82, 95% confidence interval [CI] 1.78\u20131.85). Patients with dementia were also more likely to have major complications (51.6% vs. 38.5%, aOR 1.19, 95% CI 1.17\u20131.20), be discharged to a higher level of care (75.1% vs. 41.3%, aOR 1.49, 95% CI 1.44\u20131.53), and have a prolonged SNF stay (3.7% vs. 1.4%, aOR 1.80, 95% CI 1.69\u20131.91). Although patients with ADRD were overall less likely to receive intensive interventions during the index admission and at 90\u2009days, they were more likely to receive feeding tubes (aOR 1.22, 95% CI 1.17\u20131.28).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Persons living with dementia experience a broad range of worse outcomes after high\u2010risk surgery compared to those without dementia. These data may be used for decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70091","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T10:14:51Z","timestamp":1758017691000},"page":"3434-3443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patients With Dementia Undergoing High\u2010Risk Inpatient Surgery Have Poor Outcomes"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6474-1455","authenticated-orcid":false,"given":"Samir K.","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingwei","family":"Xiang","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel R.","family":"Adler","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clancy J.","family":"Clark","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Cooper","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Finlayson","sequence":"additional","affiliation":[{"name":"Department of Surgery Phillip R. Lee Institute for Health Policy Studies, University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan L.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Hebrew SeniorLife Arthur and Hinda Marcus Institute for Aging Research  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-6838","authenticated-orcid":false,"given":"Dae Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Hebrew SeniorLife Arthur and Hinda Marcus Institute for Aging Research  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kueiyu Joshua","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart R.","family":"Lipsitz","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel S.","family":"Weissman","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18685"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17893"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.07.087"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e318267bfe3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17928"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.08.025"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010021\u201001864\u20105"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.10395"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2020.04.009"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.102409"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1819"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17183"},{"key":"e_1_2_10_14_1","unstructured":"Research Triangle Institute (RTI) \u201cRace Code | ResDAC\u201d(2024) https:\/\/resdac.org\/cms\u2010data\/variables\/research\u2010triangle\u2010institute\u2010rti\u2010race\u2010code."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31819432e5"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glx229"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly197"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.08.114"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2023.03.012"},{"key":"e_1_2_10_20_1","unstructured":"ACS NSQIP Participant Use Data File \u201cACS\u201d(2025) https:\/\/www.facs.org\/quality\u2010programs\/data\u2010and\u2010registries\/acs\u2010nsqip\/participant\u2010use\u2010data\u2010file\/."},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.552"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.755"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1964"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e238"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.5155"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(11)61268\u20103"},{"issue":"6","key":"e_1_2_10_27_1","first-page":"277","article-title":"Potential Benefits of Regionalizing Major Surgery in Medicare Patients","volume":"2","author":"Birkmeyer J. 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