PCP Visits Save Lives of Older Patients After Cancer Surgery

Edited by Lora T. McGlade

August 08, 2024

TOPLINE:
Primary care visits within 90 days after cancer surgery are linked to a lower mortality rate in older adults. Patients with a primary care visit had a 90-day mortality rate of 0.3% compared with 3.3% for those without.

METHODOLOGY:
A total of 2566 patients aged 65 years or older who underwent inpatient cancer surgery between January 1, 2017, and December 31, 2019, were included in a retrospective cohort study.
Patients were categorized on the basis of having a primary care practitioner (PCP) and whether they had a primary care visit within 90 postoperative days.
The primary outcome was 90-day postoperative mortality, analyzed using inverse propensity weighted Kaplan-Meier curves.
TAKEAWAY:
Patients with a primary care visit within 90 postoperative days had a significantly lower 90-day mortality rate (0.3%) than those without a visit (3.3%) (P = .001).
Older adults without a PCP had a higher 90-day postoperative mortality rate (3.6%) than those with a PCP (2.0%) (P = .01).
Patients who had a primary care visit were more likely to be older, have a higher comorbidity score, and have higher rates of emergency department visits and readmissions.
IN PRACTICE:
“Identifying older patients with cancer who do not have a PCP in the preoperative setting is, therefore, a potential intervention point; such patients could be referred to establish primary care or prioritized for assessment in a preoperative optimization clinic,” wrote the study authors.

SOURCE:
The study was led by Hadiza S. Kazaure, MD, of Duke University Medical Center in Durham, North Carolina. It was published online on August 7 in JAMA Surgery.

LIMITATIONS:
The study was retrospective and performed at a single institution, which may limit the generalizability of the results. Coding errors were possible, and details on potential confounders such as frailty and severity of comorbidities are lacking. Mortality was low overall, limiting further adjusted and cancer-specific analyses. Data linkage between the electronic health record and Medicare and Medicaid databases was not possible, limiting analysis of data from patients with external PCPs.

DISCLOSURES:
Kazaure disclosed receiving grants from the National Cancer Institute. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.