Study: Redefining multimorbidity in older surgical patients may improve clinical decision-making

Editor's Note

In this study, led by the University of Pennsylvania Perelman School of Medicine, Philadelphia, researchers developed and validated better surgical specialty-specific multimorbidity definitions based on distinct characteristics of older inpatients undergoing general, orthopedic, or vascular surgery.

The researchers used 2016 to 2017 Medicare administrative claims data on patients aged 66-90 years for the analysis.

Compared to conventional multimorbidity definitions, the new definitions labeled fewer patients multimorbid:

• General surgery—85.0% conventional vs 55.9% new
• Orthopedic surgery—66.6% conventional vs 40.2% new
• Vascular surgery—96.2% conventional vs 52.7% new.

In addition, 30-day mortality was higher using the new definitions:

• General surgery—3.96% conventional vs 5.64% new
• Orthopedic surgery—1.13% conventional vs 1.68% new
• Vascular surgery—4.43% conventional vs 7.00% new.

The new multimorbidity definitions identified far more specific, higher-risk patients than conventional definitions, which can help in clinical decision-making, the researchers say.