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Worse Than Death? The Older Patient and Long-Term Outcomes After Emergency General Surgery
Worse Than Death? The Older Patient and Long-Term Outcomes After Emergency General Surgery
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260209102842
- ISBN
- 9798315778127
- DDC
- 610
- 서명/저자
- Worse Than Death? The Older Patient and Long-Term Outcomes After Emergency General Surgery
- 발행사항
- [Sl] : Case Western Reserve University, 2023
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2023
- 형태사항
- 182 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-12, Section: B.
- 주기사항
- Advisor: Spilsbury, James.
- 학위논문주기
- Thesis (Ph.D.)--Case Western Reserve University, 2023.
- 초록/해제
- 요약The purpose of this dissertation is to explore baseline and acute health vulnerability factors in older patients with emergency general surgery (EGS) conditions and assess the relationships between these factors and long-term outcomes. EGS conditions, such as gastrointestinal perforation and ischemia, are life-threatening conditions which lead to 3 million admissions per year in the United States. Older adults bear a disproportionate burden of EGS case volume and morbidity, and this will become more pronounced as the population ages. Many older EGS patients already have a baseline level of aging-related health vulnerability, defined as diseases, functional limitations, social needs, and other aging-related concerns which cause declines in mental and physical health. Our current knowledge about how preexisting health vulnerability affects outcomes in EGS patients is limited.In this dissertation, I explore the interaction between baseline health vulnerability factors and acute health factors to identify and quantify factors which contribute meaningfully to post-EGS recovery. To approach this aim, I performed research using quantitative and qualitative research methods, designed to explore effects of multiple aging-related health vulnerability domains on long-term outcomes after EGS. Our central hypothesis is that specific health vulnerability factors will be meaningful for long-term outcomes in older EGS patients.This research identified several key takeaway points. Health vulnerability was entwined with the development of EGS diseases (older EGS patients had higher levels of vulnerability than non-EGS patients), use of operative management (vulnerable EGS patients were less likely to receive operations), and outcomes (vulnerable EGS patients had poorer survival). Our quantitative and qualitative work identified that functional status was both a key prognostication factor for survival and a meaningful recovery goal. Our qualitative work also identified that older EGS patients rely strongly on their social networks and support systems in the postoperative recovery period.The foundational work presented in this dissertation provides important knowledge regarding the relationships between aging-related health vulnerability and long-term outcomes in older patients with EGS conditions. I look forward to continuing this work throughout my career and develop strategies to improve alignment between patient goals and long-term health in older EGS patients.
- 일반주제명
- Medicine
- 일반주제명
- Surgery
- 일반주제명
- Aging
- 키워드
- EGS patients
- 기타저자
- Case Western Reserve University Clinical Translational Science
- 기본자료저록
- Dissertations Abstracts International. 86-12B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610
■1001 ▼aHo, Vanessa Phillis.
■24510▼aWorse Than Death? The Older Patient and Long-Term Outcomes After Emergency General Surgery
■260 ▼a[Sl]▼bCase Western Reserve University▼c2023
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2023
■300 ▼a182 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-12, Section: B.
■500 ▼aAdvisor: Spilsbury, James.
■5021 ▼aThesis (Ph.D.)--Case Western Reserve University, 2023.
■520 ▼aThe purpose of this dissertation is to explore baseline and acute health vulnerability factors in older patients with emergency general surgery (EGS) conditions and assess the relationships between these factors and long-term outcomes. EGS conditions, such as gastrointestinal perforation and ischemia, are life-threatening conditions which lead to 3 million admissions per year in the United States. Older adults bear a disproportionate burden of EGS case volume and morbidity, and this will become more pronounced as the population ages. Many older EGS patients already have a baseline level of aging-related health vulnerability, defined as diseases, functional limitations, social needs, and other aging-related concerns which cause declines in mental and physical health. Our current knowledge about how preexisting health vulnerability affects outcomes in EGS patients is limited.In this dissertation, I explore the interaction between baseline health vulnerability factors and acute health factors to identify and quantify factors which contribute meaningfully to post-EGS recovery. To approach this aim, I performed research using quantitative and qualitative research methods, designed to explore effects of multiple aging-related health vulnerability domains on long-term outcomes after EGS. Our central hypothesis is that specific health vulnerability factors will be meaningful for long-term outcomes in older EGS patients.This research identified several key takeaway points. Health vulnerability was entwined with the development of EGS diseases (older EGS patients had higher levels of vulnerability than non-EGS patients), use of operative management (vulnerable EGS patients were less likely to receive operations), and outcomes (vulnerable EGS patients had poorer survival). Our quantitative and qualitative work identified that functional status was both a key prognostication factor for survival and a meaningful recovery goal. Our qualitative work also identified that older EGS patients rely strongly on their social networks and support systems in the postoperative recovery period.The foundational work presented in this dissertation provides important knowledge regarding the relationships between aging-related health vulnerability and long-term outcomes in older patients with EGS conditions. I look forward to continuing this work throughout my career and develop strategies to improve alignment between patient goals and long-term health in older EGS patients.
■590 ▼aSchool code: 0042.
■650 4▼aMedicine
■650 4▼aSurgery
■650 4▼aAging
■653 ▼aEmergency surgery
■653 ▼aEmergency general surgery
■653 ▼aPatient-centered outcomes
■653 ▼aMixed methods research
■653 ▼aEGS patients
■690 ▼a0564
■690 ▼a0769
■690 ▼a0576
■690 ▼a0493
■71020▼aCase Western Reserve University▼bClinical Translational Science.
■7730 ▼tDissertations Abstracts International▼g86-12B.
■790 ▼a0042
■791 ▼aPh.D.
■792 ▼a2023
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17365867▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
