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https://hdl.handle.net/2440/92302
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dc.contributor.author | Pham, C. | - |
dc.contributor.author | Gibb, C. | - |
dc.contributor.author | Field, J. | - |
dc.contributor.author | Gray, J. | - |
dc.contributor.author | Fitridge, R. | - |
dc.contributor.author | Marshall, V. | - |
dc.contributor.author | Karnon, J. | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | ANZ Journal of Surgery, 2014; 84(12):925-931 | - |
dc.identifier.issn | 1445-1433 | - |
dc.identifier.issn | 1445-2197 | - |
dc.identifier.uri | http://hdl.handle.net/2440/92302 | - |
dc.description.abstract | BACKGROUND: There are a subset of potentially modifiable co-morbidities that may be targeted in the preoperative phase with a view to optimizing control and improving post-operative outcomes. This study aims to estimate the effect of potentially modifiable co-morbidities on post-operative outcomes and to identify potential targets for preoperative management. METHODS: Retrospective data on hospital separations in South Australia were analyzed using multiple regression to estimate the association between nine potentially modifiable co-morbidities and length of stay, post-operative complications and in-hospital mortality. RESULTS: After adjusting for primary diagnosis, age, gender and other potential confounders, significant increases in length of stay and complications were recorded for eight and six of the nine modifiable co-morbidities, respectively. As examples, previous heart failure was associated with a 54% increase in length of stay and an odds ratio of 1.75 for complications. Asthma and chronic obstructive pulmonary disease was associated with a 38% increase in length of stay and an odds ratio of 1.64 for complications. CONCLUSIONS: A set of potentially modifiable co-morbidities is associated with a range of poorer post-operative outcomes, relative to patients without those co-morbidities. There is a clinical rationale that outcomes will be worse in the subset of patients for whom such co-morbidities are poorly controlled, and that timely intervention to improve control in the period prior to surgery will improve post-operative outcomes. Further research is required on post-operative outcomes for patients with and without controlled co-morbidities and on the effects of timely intervention to improve control prior to surgery. | - |
dc.description.statementofresponsibility | Clarabelle Pham, Catherine Gibb, John Field, Jodi Gray, Robert Fitridge, Villis Marshall and Jonathan Karnon | - |
dc.language.iso | en | - |
dc.publisher | Wiley | - |
dc.rights | © 2014 Royal Australasian College of Surgeons | - |
dc.source.uri | http://dx.doi.org/10.1111/ans.12726 | - |
dc.subject | co-morbidity | - |
dc.subject | optimization | - |
dc.subject | outcome | - |
dc.subject | preoperative care | - |
dc.title | Managing high-risk surgical patients: modifiable co-morbidities matter | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1111/ans.12726 | - |
dc.relation.grant | http://purl.org/au-research/grants/nhmrc/1025140 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Pham, C. [0000-0003-4509-5368] | - |
dc.identifier.orcid | Gray, J. [0000-0002-1119-7078] | - |
dc.identifier.orcid | Fitridge, R. [0000-0001-6258-5997] | - |
dc.identifier.orcid | Karnon, J. [0000-0003-3220-2099] | - |
Appears in Collections: | Aurora harvest 2 Public Health publications |
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