News & Events

The United States population is rapidly aging. Older individuals are estimated to account for more than half of the procedures performed in the United States. Of those aged 70 and older who undergo major surgery, more than half are considered frail. Frailty puts patients at increased risk for adverse outcomes Multimodal rehabilitation has been shown to mitigate frailty-associated surgical risk. The Surgery Wellness Program (SWP) at UCSF demonstrated the feasibility and effectiveness of a pre-operative rehabilitation program. Despite positive patient response, 30% of referred patients [...]

Specific health measures – such as function, cognition and psychological well-being – should be incorporated into the assessment of whether major surgery is suitable for older adults, especially if the mortality risk after surgery outweighs the benefits, according to a new study by researchers at UC San Francisco. In a review of nearly 1,350 U.S. patients age 66 and older, almost 1-in-5 of those who had major surgery died within a year. Factors such as dementia and lost ability to perform activities of daily living were significantly associated with mortality, the researchers said.  

PrehabPal garnerered a top prize at the recent Robert Wood Johnson Foundation Healthcare innovation Competition. For its pitch, Ooney demoed its online app for patients preparing to undergo surgery. By providing a selection of targeted exercises or routines, the company looks to reduce the chance of poor outcomes, explained founder Dr. Emily Finlayson. "Every year, over 4 million operations are performed on frail older adults. That's nearly 50% of all major high-risk operations in the US, and we know from epidemiology that older adults suffer complications at exponentially higher rates [...]

The UCSF Center for Surgery in Older Adults is pleased to announce that we have been awarded funding from the UCSF Integrative Oncology Collaborative (IOC) for our pilot project: "PrehabPal: Digitally Enhanced Coaching to Prepare the Mind and Body for Cancer Surgery." The principal investigator on the study is Emily Finlayson MD, MS, Professor of Surgery, Medicine, and Health Policy, and Director of the Center for Surgery in Older Adults. A key component of the project is the web app "PrehabPal". Marrying high tech with high touch coaching from the patient support corps, PrehabPal evaluates [...]

"In modern surgery, it's a rare event to die from surgery," says Dr. Emily Finlayson, director of the University of California San Francisco's Center for Surgery in Older Adults. "The risk comes from being able to recover." ......Fragility, cognition, mobility, depression, how much support how someone has at home — those are all also factors to be considered. These are mostly non-traditional factors, and in particular, "fragility is an emerging concept that goes beyond chronological age. You can be eighty and really fit, or you can be fifty-five and have a lot of physical function issues and [...]

We are pleased to announce that Emily Finlayson, M.D., M.S., FACS, professor of Surgery, Medicine (Geriatrics), and Health Policy at the University of California San Francisco has been named the new Vice Chair for Faculty Affairs and Development in the Department of Surgery. Dr. Finlayson received her MD at Harvard Medical School and MS from the Center for Evaluative Clinical Sciences at Dartmouth Medical School. She completed her general surgery residency at UCSF and her fellowship in colorectal surgery at the Mayo Clinic. Her NIH-funded work includes population-based analyses, clinical [...]

Emily Finlayson, MD, MS, director of the Center for Surgery in Older Adults at UCSF,  was interviewed by Becker's Hospital Review on how hospitals work to prepare at-risk older patients for surgery, screening for frailty and meeting patient's health goals.  Older patients undergo major surgery on a regular basis. However, a number of these patients are at risk for experiencing complications, functional decline and loss of independence after surgery. With this in mind, Emily Finlayson, MD,  professor of surgery and health policy at University of California - San Francisco Medical Center, [...]

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America's 45 million seniors and their families navigate the health care system. Surgery can be hard on older adults, resulting in serious complications and death far more often than in younger patients. But many seniors aren't adequately prepared for the risks they might face. Innovative hospitals such as Duke University Medical Center, the University of California-San Francisco Medical Center and Michigan Medicine are working to change that. In the weeks leading up to surgery, they [...]

Carolyn D. Seib, M.D., MAS, a clinical investigator and member of the UCSF endocrine surgery faculty, has been awarded a RAP (Resource Allocation Program) seed grant by the Helen Diller Family Comprehensive Cancer Center to study postoperative cognitive dysfunction in elderly patients undergoing surgery for thyroid cancer. Dr. Seib's project is part of her ongoing research focused on individualizing the surgical care of older adults. With increasing evidence supporting the surveillance of small, low-risk papillary thyroid cancers, the decision of whether to manage thyroid cancer operatively [...]

A new research study shows that patient frailty should be assessed in preoperative planning for surgery in older adults, even for common ambulatory general surgery operations. The study, led by principal investigator and lead author, Carolyn D. Seib, M.D., MAS, a general and endocrine surgeon at UCSF, was reported on in the journal JAMA Surgery and highlighted by the NY Times in a subsequent article. Importantly, the study found that frailty is more closely associated with the risk of complications than  chronological age. It has implications for both treatment planning and informed consent [...]

The Spring/Summer 2017 issue of Inside Surgery is now available online. Inside Surgery is a Department of Surgery brochure showcasing the clinical and research advances of our faculty. The edition highlights minimally invasive bariatric surgery to treat metabolic disease, and robotic surgery deployed across a variety of surgical specialties within the Department. The newsletter begins with a tribute to the outgoing Chair, Nancy L. Ascher, M.D., Ph.D. via a letter from the Interim Chair: UCSF Medical Center has long been at the forefront of innovation in every facet of surgery. Our [...]

Jennifer Kaplan, M.D., a research resident in the UCSF General Surgery Residency Program, received the award for Best Trainee Poster Presentation from the Academy for Healthcare Improvement (AHI) at the organization's 2015 annual meeting.  The presentation, "Health Coaching By Health Professions Students for Frail Older Adults Scheduled for High Risk Elective Surgery", was developed by members of a multidisciplinary research group in the UCSF Center for Surgery in Older Adults (CSOA). In addition to lead presenter Jennifer Kaplan, MD, collaborators in the development of the presentation [...]

A research team at the UCSF Center for Surgery in Older Adults (CSOA)  including faculty, research residents, staff and students, gave a poster presentation about the UCSF Surgery Wellness Program entitled, Get Fit for Surgery: An Interdisciplinary Geriatric Surgery Wellness Program, at the 5th Annual Quality and Safety Symposium hosted by the UCSF Department of Medicine on May 28, 2015. The presentation reported on early results on this new clinical intervention, which launched in February 2015 at UCSF Medical Center at Mission Bay  The goal of the Quality and Safety Innovation Challenge [...]

UCSF News reports that U.S. only a small number of nursing home residents are alive and ambulatory one year after undergoing lower extremity revascularization procedures with those still alive gaining little, if any, function: Only a few U.S. nursing home residents who undergo lower extremity revascularization procedures are alive and ambulatory a year after surgery, according to UCSF researchers, and most patients still alive gained little, if any, function. The study appears in the April 6 issue of JAMA Internal Medicine. "Our findings can inform conversations among physicians, [...]

Shirley Chan, a medical student at the UC Berkeley-UCSF Joint Medical Program, has been awarded the Medical Student Training in Aging Research (MSTAR) fellowship from the American Federation of Aging Research (AFAR) and the National Institute on Aging (NIA). She will be working with the UCSF Center for Surgery in Older Adults to study hospital to home transitions for vulnerable elders who undergo elective high-risk surgery. Her goal is to develop and implement care pathways that prevent hospital readmissions, functional decline, and loss of independence. In the past, Shirley worked in the [...]

UCSF News reports that Jennifer Lai, MD, MBA, a general and transplant hepatologist and assistant clinical professor in the UCSF Division of Gastroenterology and Hepatology, has been honored for her "patient-oriented clinical research within the core principles of geriatrics (i.e., frailty, disability, lag-time benefit) to cirrhosis patients and liver transplant patients, organ allocation and distribution, and liver donor quality." UC San Francisco's Jennifer Lai, MD, MBA, was recently selected as a "Top 40 under 40" in the Class of 2015 by the San Francisco Business Times. She is the only [...]

Drs. Emily Finlayson and Jennifer Kaplan received the Innovations Funding for Education Award for their proposal: 'Integrating Interprofessional Learners in High Risk Surgical Patient Care'.  Funded by the Academy of Medical Educators Innovation Program, the UCSF Library & Center for Knowledge Management/UCSF Program in Interprofessional Education, and Tideswell at UCSF, their novel new education model links trainee learning with future practice of highly interdisciplinary care of older surgical patients. This longitudinal curriculum for early medical and nurse practitioner students [...]

The UCSF Center for Surgery in Older Adults (CSOA) has published its inaugural Winter 2015 Newsletter: Greetings from the UCSF Surgery Wellness Program. As 2015 draws to a close, we would like to thank our patients, families, and supporters for all they have contributed to this exciting new initiative. We are delighted that our program continues to grow and flourish. With the help of a dedicated care team in the clinic, we are innovating approaches to individualized care for older patients undergoing surgery. Alicia Rivas, Laurie Kramer, and Kaitlyn Attiga are refining tailored approaches [...]

The Department of Surgery has launched a new program, the UCSF Center for Surgery in Older Adults (CSOA). Led by Emily Finlayson, M.D., M.S., an Associate Professor of Surgery and Health Policy, the program seeks to discover and implement patient-centered best practices in geriatric surgery that will help older patients achieve their treatment goals and maintain independence and vitality. The UCSF Center for Surgery in Older Adults Research Collaborative includes investigators from a broad range of disciplines – surgery, anesthesia, rehabilitation services, geriatrics, palliative care, [...]

Alexander Smith, M.D., MPH  discusses trends and news ideas about surgical outcomes percolating among thought leaders in the field including Emily Finlayson, M.D., M.S., Associate Professor of Surgery and Health Policy at UCSF, in a post at GeriPal, a geriatrics and palliative care blog. A while back people realized that outcomes of surgery in older people were probably better than previously believed. This led to a widespread perception that we were being ageist by not being aggressive enough in offering surgery to older adults.  We started operating on more older adults. We identified [...]