The impact of multimorbidity on long-term outcomes for older emergency general surgery patients remains unclear. The present study thus identified Medicare beneficiaries aged 65 and older who underwent operative management of an emergency general surgery condition using Centers for Medicare & Medicaid claims data. 

It classified the Patients as multimorbid based on the presence of a Qualifying Comorbidity Set (a specific combination of comorbid conditions known to be associated with increased risk of in-hospital mortality in the general surgery setting) and compared with those without multimorbidity. The study then calculated Risk-adjusted outcomes through 180 days after discharge from index hospitalization using linear and logistic regressions. 

The study observed-

• Inclusion of 174,891 patients and identification of 45.5% as multimorbid.
• Higher mortality rates among Multimorbid patients during index hospitalization and through 6 months after discharge.
• Higher rates of readmission at one month and six months after discharge, lower rates of discharge to home, higher rates of discharge to rehabilitation/nursing facility, greater than double the use of home oxygen, walker, wheelchair, bedside commode, and hospital bed, a longer length of index hospitalization, and higher costs through 6 months among Multimorbid patients.

This study explains that older, multimorbid patients experience worse outcomes, including survival and independent function, after emergency general surgery than nonmultimorbid patients through 6 months after discharge from the index hospitalization. Sharing this information with high-risk patients helps them make better decisions about their recovery.

Journal of the American College of Surgeons. 2022 Nov 1;235(5):724-735. Doi: 10.1097/XCS.0000000000000303.