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Invited Commentary
December 2018

Surgical Decision Making in Elderly, Impaired Nursing Home Patients

Author Affiliations
  • 1Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois
  • 2Department of Surgery, Emory University, Atlanta, Georgia
  • 3Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 4Northwestern Institute for Comparative Effectiveness Research in Oncology (NICER-Onc), Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA Surg. 2018;153(12):1096-1097. doi:10.1001/jamasurg.2018.2737

In the United States, the life expectancy of an 80-year-old woman is 9 more years; however, half of these women are likely to live more than 13 years, and the other half are likely to live less than 5 years.1 Given this, nursing home patients presumably have a life expectancy that is shorter than the average. In this issue of JAMA Surgery, Tang et al2 evaluated the 30-day and 1-year mortality and functional decline of nursing home patients after breast cancer surgery (mean [SD] age, 82 [7] years). This cohort of patients had high levels of preoperative comorbidities and functional dependence. The authors found significantly higher rates of 30-day mortality, 1-year mortality, and functional decline in this cohort, and those who were the least functionally independent had the highest mortality rates.

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