Adults get more surgery at end of life, new study

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Oct 8 2011 - 8:36pm

In a study released Oct. 5 in The Lancet, researchers found that the older a person gets, the more surgery he has, increasing in the later years and even increasing more within the last week of life.

The study showed that one in three adults had surgery in the last year of life. One in five adults had surgery within the last month of life. And one in 10 adults had surgery in the last week of life.

The research has been highly criticized though, with other researchers suggesting by observing only those who are dying, the results might be skewed.

“Because the patient died, you can’t assume that the treatment and therapies were not of value,” said Dr. Peter B. Bach of Memorial Sloan-Kettering Cancer Center in The New York Times. “Although in that individual, things may not have worked out, you have no insight into whether the decision to operate was appropriate.”

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In addition, he said, a researcher cannot know how many patients who had the same surgery didn’t die.

The researchers conducting the study looked at records for all Medicare patients who died in 2008. There were 1,802,029 patients who had Medicare and died that year.

One of the authors of the study said he himself was guilty of sometimes giving out more surgeries at the end of life.

“I will admit to being guilty of this,” lead author and Assocate Professor at Harvard Dr. Ashish Jha said in The New York Times. “Often we say, ‘If you have this intervention, we will be able to fix that problem. You have an intestinal blockage. Surgery will fix it.’ But will it let you walk out of the hospital alive? Will it let you return to your old life?”

“As clinicians, we often end up focusing on something narrow and small that we think we can fix,” Jha added. “That leads us down the path of surgical intervention. But what the patient cares about is not going to get fixed.”

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