# Emergency General Surgery Treatment of Older Multimorbid Patients

> **NIH NIH F32** · UNIVERSITY OF PENNSYLVANIA · 2021 · $73,062

## Abstract

PROPOSAL SUMMARY/ABSTRACT
Each year in the United States, there are three million emergency general surgery hospital admissions, with 30%
of these patients requiring surgical intervention. Multimorbid, older patients are a complex population
encompassing immense health resource utilization, but outcomes data regarding the impact of multimorbidity on
older emergency general surgery patients are lacking. This limits surgeon ability to set realistic expectations for
patients, which is key to enacting goal-concordant care. Patient-centered care is a national standard under the
Patient Protection and Affordable Care Act and has been shown to improve health outcomes and patient
satisfaction. The “Best case/Worst case” communication tool is a validated instrument to facilitate treatment
choice by using scenario planning to improve patient understanding of realistic outcomes. The impact of data on
the use of this tool, however, has not yet been characterized. This project will (1) define the impact of
multimorbidity on outcomes for older patients requiring emergency general surgery operations using
comprehensive nationwide data analysis, (2) characterize the barriers and facilitators of integrating novel data
into the Best case/Worst case communication tool through focus groups and complex qualitative analysis, and
(3) create an education tool kit to integrate data into using the Best case/Worst case tool using implementation
science. Beyond supporting the above research, the training goal of this project is to further Dr. Claire Rosen’s
training in mixed methods biomedical ethics research with a focus on patient communication, and to prepare her
to become an independent investigator. The above grant will support the education of Dr. Rosen, who will pursue
a Master of Science in Medical Ethics through the University of Pennsylvania Department of Medical Ethics and
Health Policy. This degree program has a primary goal of training physician-scientists aspiring to empirically
oriented bioethics faculty positions in academic medical centers through structured content and scientific
methods coursework and mentored research. This project fills a knowledge gap regarding the outcomes of
multimorbid older emergency general surgery patients and uses qualitative analysis and implementation science
to improve patient-centered care and communication, striving towards national demands for higher quality care.
The work will be a major step in enabling Dr. Rosen to become an independent investigator, expert in biomedical
ethics, and advocate for older, multimorbid emergency general surgery patients.

## Key facts

- **NIH application ID:** 10315304
- **Project number:** 1F32AG074614-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Claire Rosen
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $73,062
- **Award type:** 1
- **Project period:** 2021-08-23 → 2023-08-22

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10315304

## Citation

> US National Institutes of Health, RePORTER application 10315304, Emergency General Surgery Treatment of Older Multimorbid Patients (1F32AG074614-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10315304. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*