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  1. Article ; Online: Palliative surgery: state of the science and future directions.

    Lilley, Elizabeth J / Farber, Orly N / Cooper, Zara

    The British journal of surgery

    2024  Volume 111, Issue 3

    Abstract: Palliative surgical procedures are operations that aim to alleviate symptoms in a patient with serious, life-limiting illness. They are common, particularly within the field of surgical oncology. However, few high-quality studies have attempted to ... ...

    Abstract Palliative surgical procedures are operations that aim to alleviate symptoms in a patient with serious, life-limiting illness. They are common, particularly within the field of surgical oncology. However, few high-quality studies have attempted to measure the durability of improvements in symptoms and quality of life after palliative surgery. Furthermore, many of the studies that do exist are outdated and employ highly inconsistent definitions of palliative surgery. Consequently, the paucity of robust and reliable evidence on the benefits, risks, and trade-offs of palliative surgery hampers clinical decision-making for patients and their surgeons. The evidence for palliative surgery suggests that, with effective communication about goals of care and careful patient selection, palliative surgery can provide symptomatic relief and reduce healthcare burdens for certain seriously ill patients.
    MeSH term(s) Humans ; Palliative Care/methods ; Quality of Life
    Language English
    Publishing date 2024-03-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znae068
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Indicated But Not Always Appropriate: Surgery in Terminally Ill Patients With Abdominal Catastrophe.

    Cooper, Zara

    Annals of surgery

    2018  Volume 268, Issue 1, Page(s) e4

    MeSH term(s) Humans ; Palliative Care ; Patients ; Surveys and Questionnaires ; Terminally Ill ; Viscera
    Language English
    Publishing date 2018-05-04
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000002777
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  3. Article ; Online: Which Priorities Should Guide Palliative Surgical Research?

    Cooper, Zara / Cauley, Christy

    AMA journal of ethics

    2021  Volume 23, Issue 10, Page(s) E806–810

    Abstract: Research priorities in surgical palliative care should go beyond generating data from traditional surgical morbidity or mortality metrics. Surgical researchers can seek to better understand care management complexities of surgical patients with serious ... ...

    Abstract Research priorities in surgical palliative care should go beyond generating data from traditional surgical morbidity or mortality metrics. Surgical researchers can seek to better understand care management complexities of surgical patients with serious illnesses in order to gather high-quality, patient-centered data; improve surgical patients' experiences; and motivate surgical palliative care as a field.
    MeSH term(s) Humans ; Palliative Care
    Language English
    Publishing date 2021-10-01
    Publishing country United States
    Document type Journal Article
    ISSN 2376-6980
    ISSN (online) 2376-6980
    DOI 10.1001/amajethics.2021.806
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  4. Article ; Online: An Honest Look in the Mirror - Cultivating a Culture of Equity in Surgery.

    Mehtsun, Winta T / Cooper, Zara

    Annals of surgery

    2021  Volume 273, Issue 1, Page(s) e1–e2

    MeSH term(s) Continental Population Groups ; General Surgery ; Health Equity ; Healthcare Disparities ; Humans ; Surgical Procedures, Operative ; United States
    Language English
    Publishing date 2021-01-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000004519
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  5. Article ; Online: Trajectories of Postoperative Depressive Symptoms in Older Patients Undergoing Major Surgery.

    Cenzer, Irena / Inouye, Sharon K / Raue, Patrick J / Keny, Christina / Cooper, Zara / Tang, Victoria L

    JAMA network open

    2024  Volume 7, Issue 1, Page(s) e2354154

    MeSH term(s) Aged ; Humans ; Depression/epidemiology ; Postoperative Period
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.54154
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  6. Article ; Online: Geriatric Assessment in Colorectal Surgery: A Systematic Review.

    Cauley, Christy E / Samost-Williams, Aubrey / Philpotts, Lisa / Brindle, Mary / Cooper, Zara / Ritchie, Christine S

    The Journal of surgical research

    2024  Volume 296, Page(s) 720–734

    Abstract: Introduction: The prevalence of colorectal surgery among older adults is expected to rise due to the aging population. Geriatric conditions (e.g., frailty) are risk factors for poor surgical outcomes. The goal of this systematic review is to examine how ...

    Abstract Introduction: The prevalence of colorectal surgery among older adults is expected to rise due to the aging population. Geriatric conditions (e.g., frailty) are risk factors for poor surgical outcomes. The goal of this systematic review is to examine how current literature describes geriatric assessment interventions in colorectal surgery and associated outcomes.
    Methods: Systematic searches of Ovid MEDLINE, Cochrane Library, CINAHL, Embase, and Web of Science were completed. Review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and prospectively registered in PROSPERO, the international prospective register of systematic reviews in health and social care. All cohort studies and randomized trials of adult colorectal surgery patients where geriatric assessment was performed were included. Geriatric assessment with/without management interventions were identified and described.
    Results: Seven-hundred ninety-three studies were identified. Duplicates (197) were removed. An additional 525 were excluded after title/abstract review. After full-text review, 20 studies met the criteria. Reference list review increased final total to 25 studies. All 25 studies were cohort studies. No randomized clinical trials were identified. Heterogeneous assessments were organized into geriatrics domains (mind, mobility, medications, matters most, and multi-complexity). Incomplete evaluations across geriatric domains were performed with few studies describing the use of assessments to impact management decisions.
    Conclusions: There are no randomized trials assessing the impact of geriatric assessment to tailor management strategies and improve outcomes in colorectal surgery. Few studies performed assessments to evaluate the geriatric domain matters most. These findings represent a gap in evidence for the efficacy of geriatric assessment and management strategies in colorectal surgical care.
    MeSH term(s) Humans ; Aged ; Geriatric Assessment ; Colorectal Surgery ; Frailty/diagnosis ; Aging ; Digestive System Surgical Procedures
    Language English
    Publishing date 2024-02-16
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2023.12.055
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  7. Article ; Online: Assessing performance of Geriatric Surgery Verification Program preoperative communication standards in spine surgery.

    Agaronnik, Nicole D / Streid, Jocelyn L / Kwok, Anne / Schoenfeld, Andrew J / Cooper, Zara / Lindvall, Charlotta

    Journal of the American Geriatrics Society

    2024  Volume 72, Issue 4, Page(s) 1136–1144

    Abstract: Background: To assess performance of the American College of Surgeons Geriatric Surgery Verification (GSV) Program preoperative communication standards in older patients undergoing high risk spine surgery.: Methods: We performed an external ... ...

    Abstract Background: To assess performance of the American College of Surgeons Geriatric Surgery Verification (GSV) Program preoperative communication standards in older patients undergoing high risk spine surgery.
    Methods: We performed an external validation of a natural language processing (NLP) method for identifying documentation meeting GSV communication standards. We then applied this method to a retrospective cohort of patients aged 65 and older who underwent spinal fusion procedures between January 2018-December 2020 in a large healthcare system in Massachusetts. Our primary outcome of interest was fulfillment of GSV communication domains: overall health goals, treatment goals, and patient-centered outcomes. Factors associated with the fulfillment of at least one domain were assessed using Poisson regression to adjust for confounding.
    Results: External validation of the NLP method had a sensitivity of 88.6% and specificity of 99.0%. Our study population included 1294 patients, of whom only 0.8% (n = 10) patients contained documentation of all three GSV domains, and 33.7% (n = 436) had documentation fulfilling at least one GSV domain. The GSV domain with lowest frequency of documentation was overall health goals, with only 35 (2.7%) of patients meeting this requirement. Adjusted analysis suggested that patients with a Charlson comorbidity score of one or more had higher fulfillment of GSV criteria (CCI 1-3: prevalence rate ratio (PRR) 1.8, 95% confidence interval (CI) 1.5-2.1; CCI >3: PRR 1.5, 95% CI 1.2-1.9).
    Conclusion: A paucity of geriatric patients undergoing spine surgery had preoperative documentation consistent with GSV standards. Given that spine surgery is one of the highest risk surgeries in older adults and GSV standards are relevant to all surgical specialties, wider promulgation of these standards is warranted.
    MeSH term(s) Humans ; Aged ; Retrospective Studies ; Postoperative Complications/epidemiology ; Spinal Fusion/adverse effects ; Outcome Assessment, Health Care ; Massachusetts
    Language English
    Publishing date 2024-01-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.18749
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  8. Article ; Online: The Frailty Syndrome: A Critical Issue in Geriatric Oncology.

    Minami, Christina A / Cooper, Zara

    Critical care clinics

    2020  Volume 37, Issue 1, Page(s) 151–174

    Abstract: The number of older adults with cancer is growing in the United States, and there is a relative paucity of data relating the presence of frailty with its outcomes of interest. The authors present the surgical oncology, radiation oncology, and medical ... ...

    Abstract The number of older adults with cancer is growing in the United States, and there is a relative paucity of data relating the presence of frailty with its outcomes of interest. The authors present the surgical oncology, radiation oncology, and medical oncology literature with respect to the presence of frailty in older adults with cancer. More research is needed to understand how the presence of frailty should be used by surgical, radiation, and medical oncologists to guide patient counseling and treatment planning.
    MeSH term(s) Aged ; Frail Elderly ; Frailty/diagnosis ; Geriatric Assessment ; Humans ; Medical Oncology ; Neoplasms/complications ; Neoplasms/therapy
    Language English
    Publishing date 2020-10-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2020.08.007
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  9. Article ; Online: To Face Coronavirus Disease 2019, Surgeons Must Embrace Palliative Care.

    Cooper, Zara / Bernacki, Rachelle E

    JAMA surgery

    2020  Volume 155, Issue 8, Page(s) 681–682

    MeSH term(s) COVID-19/therapy ; Family ; Humans ; Interdisciplinary Communication ; Pain Management ; Palliative Care/methods ; Patient Care Planning ; Physician-Patient Relations ; Professional-Family Relations ; Prognosis ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-04-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2020.1698
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  10. Article ; Online: Use of Palliative Interventions at End of Life for Advanced Gastrointestinal Cancer.

    Chen, Vivi W / Portuondo, Jorge I / Cooper, Zara / Massarweh, Nader N

    Annals of surgical oncology

    2022  Volume 29, Issue 12, Page(s) 7281–7292

    Abstract: Background: Despite the well-established benefits of palliative care, little is known about the use of palliative interventions among patients with advanced gastrointestinal (GI) cancer near the end of life (EOL).: Methods: A national cohort study ... ...

    Abstract Background: Despite the well-established benefits of palliative care, little is known about the use of palliative interventions among patients with advanced gastrointestinal (GI) cancer near the end of life (EOL).
    Methods: A national cohort study analyzed 142,304 patients with advanced GI cancers (stage 3 or 4) near EOL (death within 1 year of diagnosis) in the National Cancer Database (2004-2014) who received palliative interventions (defined as treatment to relieve symptoms: surgery, radiation, chemotherapy, and/or pain management). The study used multivariable hierarchical regression evaluate the association between the use of palliative interventions, temporal trends, and patient and hospital factors.
    Results: Overall, 16.5% of the patients were treated with a palliative intervention, and use increased over time (13.4% in 2004 vs 19.8% in 2014; trend test, p < 0.001). Palliative interventions were used most frequently for esophageal cancer (20.6%) and least frequently for gallbladder cancer (13.3%). Palliative interventions were associated with younger age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-0.99), recent diagnosis year (OR, 1.05; 95% CI, 1.04-1.06), black race (white [ref]; OR, 1.07; 95% CI, 1.01-1.12), insurance status (no insurance [ref]; private: OR, 0.92; 95% CI ,0.95-0.99), hospital type (community cancer program [ref]; integrated network cancer programs: OR, 1.37; 95% CI ,1.07-1.75), and stage 4 disease (OR, 2.17; 95% CI, 2.07-2.27). Patients in southern and western regions were less likely to receive palliative intervention (Northeast [ref]; OR, 0.76; 95% CI, 0.62-0.94 and OR 0.46; 95% CI, 0.37-0.57, respectively).
    Conclusion: Increased palliative intervention use over time suggests ongoing changes in how care is delivered to GI cancer patients toward EOL. However, sociodemographic and geographic variation suggests opportunities to address barriers to optimal EOL care.
    MeSH term(s) Cohort Studies ; Death ; Gastrointestinal Neoplasms/therapy ; Humans ; Neoplasms/drug therapy ; Palliative Care ; Retrospective Studies ; Terminal Care
    Language English
    Publishing date 2022-08-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-022-12342-1
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