The investigators will conduct a population-based study using health administrative data to evaluate the impact of preoperative geriatric consultation on postoperative outcomes in older patients having elective, non-cardiac surgery
The investigators will use multilevel multivariable analyses to measure the association between preoperative geriatric assessment or consultation and outcomes after major elective non-cardiac surgery. Sensitivity analyses will be done to evaluate types and timing of geriatric care around surgery, as well as for effect modification based on patient and procedural factors.
Study Type
OBSERVATIONAL
Enrollment
266,499
A preoperative geriatric consult or assessment will be considered to be present if such a consult or assessment is billed by a geriatrician for a patient in the cohort within 4 months preceding surgery. For the primary analysis we will collapse both geriatric consultations and comprehensive geriatric assessments into a single exposure level.
No assessment or consult billed in the 4 months before surgery
Ottawa Hospital Research Institute
Ottawa, Ontario, Canada
Number of Participants With All-Cause Mortality at 90-days
Death from any cause in the 90 days after surgery
Time frame: date of surgery to 90 days after surgery
Patient Safety Event
Any Type 2 diagnostic code for a patient-safety event
Time frame: From surgery to hospital discharge (on average 6 to 7 days)
Hospital Length of Stay
Time frame: date of surgery to date of hospital discharge, or 365 days after surgery, whichever comes first
Non-independent Discharge Location
Discharge disposition from hospital record that is not a home discharge without support
Time frame: date of surgery to date of hospital discharge, or 365 days after surgery, whichever comes first
30-day Hospital Readmission
New acute care hospitalization within 30-days of discharge from the index hospitalization
Time frame: Date of discharge (on average 6 to 7 days) to 30 days after discharge (on average 5 weeks)
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