Dementia is Associated With Inferior Outcomes Following Emergency General Surgery
Abstract
Introduction: Given the steadily aging United States population, we used a national database to examine the association of dementia with clinical and financial outcomes following emergency general surgery. Methods: All adults undergoing non-elective appendectomy, cholecystectomy, small bowel resection, large bowel resection, repair of perforated ulcer, or lysis of adhesions were identified within the 2016-2019 Nationwide Readmissions Database. Entropy balancing and multivariable regressions were used to assess the risk-adjusted association between dementia and in-hospital mortality, complications, length of stay, costs, non-home discharge, and 30-day unplanned readmissions. Results: Of an estimated 1,332,922 patients, 2.7% had dementia. Compared to those without, patients with dementia were older, more commonly male, and had a greater burden of chronic conditions. Following entropy balancing and multivariable risk-adjustment, dementia was associated with increased odds of mortality and sepsis across all operations except perforated ulcer repair. Dementia was also linked to greater likelihood of pneumonia across all operative categories. Moreover, dementia was associated with increased length of stay for patients in all operative categories except perforated ulcer repair, while costs were only increased for those undergoing appendectomy, cholecystectomy, and lysis of adhesions. Dementia was also linked to higher odds of non-home discharge following all operations, while non-elective readmissions were only increased for patients undergoing cholecystectomy. Conclusions: The present study found dementia to be associated with a significant clinical and financial burden. Our findings may help inform shared decision making with patients and their families.
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Inconsistencies in the standard of care from admission and during the hospital stay were associated with reduced patient wellbeing and potential inequitable access to care, which increased the risk of readmission.
“Inconsistencies in the standard of care from admission and during the hospital stay (potentially explained in part by a lack of standardised information exchange) were associated with reduced patient wellbeing and potential inequitable access to care, which increased the risk of readmission [28, 39–43].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [42]
Collaboration between healthcare professionals was associated with delayed discharges, emphasising the problem in care co-ordination.
“As a result, collaboration between HCPs was associated with delayed discharges, emphasising the problem in care co-ordination (CMOC19) [40, 42, 74, 83, 88, 91, 92].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [42]
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- Authors
- Verma, A., Branche, C., Chervu, N. L., Sakowitz, S., Bakhtiyar, S. S., Hadaya, J., & Benharash, P.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Benharash, Peyman
- Venue
- The American Surgeon™
- Publisher
- SAGE Publications
- Published
- 2023-05-03
- Volume
- 89
- Issue
- 10
- Pages
- 3994-3999
- ISSN
- 0003-1348 (ISSN-L)
- 1555-9823
- OpenAlex
- W4367833881
- Cited by
- 6
- References
- 18
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Surgeon (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- dementia, emergency general surgery, in-hospital mortality, postoperative complications, sepsis, pneumonia, length of hospital stay, hospital costs, unplanned hospital readmission, non-home discharge, appendectomy, cholecystectomy, adhesiolysis, shared decision-making
- MeSH terms
- Acute Care Surgery, Adult, Colectomy, Dementia, Humans, Length of Stay, Male, Patient Readmission, Postoperative Complications, Retrospective Studies, Risk Factors, Ulcer, United States
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