Introduction: As the number of elderly patients requiring surgical intervention rises, it is believed that frailty syndrome has a greater impact on perioperative course than on chronological age. The aim of this study was to evaluate the efficacy of various imaging features for frailty assessment in patients undergoing emergency laparotomy. Methods: The study included all patients that qualified for emergency surgery with preoperative CT scans between 2016 and 2020 in the Second Department of General Surgery. Multiple trauma patients were excluded from the analysis. The modified frailty index and brief geriatric assessment were used in the analysis. CT images were reviewed for the assessment of osteopenia, sarcopenia, sarcopenic obesity, renal volume and abdominal aorta calcification rate. Results: A total of 261 patients were included in the analysis. Multivariate logistic regression identified every next ASA class (OR: 4.161, 95%CI: 1.672–10.355, p = 0.002), intraoperative adverse events (OR: 12.397, 95%CI: 2.166–70.969, p = 0.005) and osteopenia (OR: 4.213, 95%CI: 1.235–14.367, p = 0.022) as a risk factor for 30-day mortality. Our study showed that every next ASA class (OR: 1.952, 95%Cl: 1.171–3.256, p = 0.010) and every point of the BGA score (OR: 1.496, 95%Cl: 1.110–2.016, p = 0.008) are risk factors for major complications. Conclusions: Osteopenia was the best parameter for perioperative mortality risk stratification in patients undergoing emergency surgical intervention. Sarcopenia (measured as psoas muscle area), sarcopenic obesity, aortic calcifications and mean kidney volume do not predict poor outcomes in those patients. None of the radiological markers appeared to be useful for the prediction of perioperative morbidity.
In an effort to promote comparative research on pensions, the Gateway to Global Aging Data is developing harmonized cross-national panel data on pension benefits and retirement incentives. Past research has varied in how it predicts pension benefits for individuals who have not yet claimed their benefits when administrative data on earnings histories is unavailable. We use the Gateway data to evaluate several alternative approaches to computing prospective pension benefits using common survey questions and validate them against matched administrative data. We find that in some settings naïve measures of pension benefit growth from continued work and delayed benefit claiming can perform as well as measures based on administrative data. We also find that prospective benefit levels are sensitive to the heterogeneity of lifecycle earnings dynamics, resulting in substantial measurement error even after accounting for work history.
Between 2002 and 2015, temporary employment in Poland more than doubled. Poland became the country with the highest share of temporary jobs in the EU. In this paper, we study how this process affected job quality and job quantity. We analyse the gaps between temporary and permanent workers in six dimensions of jobs quality, adopting measures proposed by the OECD and Eurofound. Of these gaps, the differences in earnings quality, job security, and work scheduling quality were the most pronounced. Job quality has improved for both groups of workers, but the gaps have not closed completely. Firms in Poland prefer to employ temporary rather than permanent workers because of the lower firing costs, tax wedges, and wages associated with temporary contracts. We use a stylised labour demand model to quantify the upper bound of a potential job creation effect due to lower labour costs incurred through the use of temporary contracts. We find that this effect did not exceed 4% of dependent employment in 2015. We cannot rule out the possibility that the net employment effect was zero. Our findings show that even if the availability of less-costly temporary contracts caused some additional jobs to be created, temporary workers suffered from lower job quality in several dimensions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.