*Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Center for Surgery and Health Economics, University of Pennsylvania Perelman School of Medicine, The Leonard Davis Institute of Health Economics, The University of Pennsylvania, Philadelphia, PA

†Department of Surgery, Center for Surgery and Health Economics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

‡Department of Anesthesia and critical Care Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

§Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Center for Surgery and Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

∥Department of Emergency Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

¶Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania Perelman School of Medicine, The Leonard Davis Institute of Health Economics, The University of Pennsylvania, Philadelphia, PA

This manuscript reports the results of an intensive, complex analysis using sophisticated statistical methods to analyze complex clinical decision-making. There are 11 authors, all of whom made substantial contributions to this work. All authors give final approval of the work. R.K., E.K., L.K., and C.W. designed the study. C.W. and R.K. acquired the data. C.W., L.K., and D.S. analyzed the data. E.K. drafted the manuscript. E.K., R.K., M.N., A.G., C.R., and S.R. provided critical feedback throughout the analytic process. All authors provided critical reviews of the manuscript.

Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG060612.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funder had no role in the design or conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

The authors report no conflicts of interest.

[email protected].

Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website, www.annalsofsurgery.com.