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Invited Commentary
March 11, 2020

Reframing Surgical Risk Using Geriatric Assessment Measures

Author Affiliations
  • 1Department of Medicine, Duke University Medical Center, Durham, North Carolina
  • 2Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, North Carolina
  • 3Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina
  • 4Durham VA Health Care System, Durham, North Carolina
  • 5Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
  • 6Department of Surgery, Duke University Medical Center, Durham, North Carolina
JAMA Surg. Published online March 11, 2020. doi:10.1001/jamasurg.2020.0092

Surgeons generally believe they are good at determining whether a patient is likely to tolerate surgery. However, evidence suggests that surgeons’ clinical intuition may not always be accurate1 and more is needed to assess the vulnerabilities of older surgical patients. In this issue of JAMA Surgery, Tang et al2 describe a longitudinal study using Health and Retirement Study data obtained from questionnaires on functional abilities, mood, and cognitive functioning and report the association with post-operative mortality after major surgery. In their cohort, up to 43% of the patients had some form of physical limitation, a quarter (25%) had depression, 23% had cognitive impairment, and 6% were dependent in 1 instrumental activity of daily living. Each of these factors was found to be associated with 1-year mortality.

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