Results of General Surgical Treatment of Patients Over 80 Years of Age in Single-Site Experience

• Authors: Patryk Fiszer , Ryszard Pogorzelski , Sadegh Toutounchi , Małgorzata Szostek , Ewa Krajewska , Wawrzyniec Jakuczun , Robert Tworus , Maciej Skórski
• Languages of publication: EN

Abstracts

EN

The aim of the study was to evaluate the results of general surgical treatment of patients over 80 years of age.Material and methods. Three hundred and four patients aged 80 to 105 years with general surgical disorders, treated in 2005-2009, were retrospectively included in the study. The collected information included demographic data, coexisting diseases, the mode of admission, the diagnosis, the method and result of treatment, and also potential complications and 30-day mortality. The data were subjected to statistical analysis.Results. The study group included 186 women and 118 men. Two hundred patients (65.8%) were admitted in an emergency setting. The most common causes of immediate hospitalisation were: mechanical ileus (26.5%), gastrointestinal bleeding (22%), trauma (16%), and gall-bladder disorders (8.5%). The remaining 104 (34.2%) patients were operated upon on an elective basis. An emergency operation was required by 121 (60%) of the patients admitted in an emergency setting; the remaining ones were treated conservatively. Hernia plasties (27.5%), cholecystectomies (15.3%), colorectal resections (13.2%), strumectomies (11.2%) and endoscopies (6.1%) predominated among elective surgeries.The total number of complications and mortality were 19.4% and 14.5%, respectively. The number of complications and mortality were significantly higher in the group of patients admitted in an emergency setting (25.5% and 20.5%, respectively) than in patients admitted on an elective basis (8.7% and 2.9%, respectively), p<0.01.The mean duration of hospitalisation was 9.7 days (1 to 60 days), with a small difference between the groups of patients treated on an elective and emergency basis (8.5 and 10.4 days), p=0.181.Conclusions. The results of surgical treatment of elderly patients do not significantly differ from the results of treatment of the general population. Much worse results, coupled with a significant increase in mortality, are observed in patients admitted and treated on an emergency basis.

Keywords

EN

surgery of elderly patients   eighty-year-old patients   surgical outcomes  

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 4
• Pages: 173-176

Dates

published

1 - 4 - 2012

online

14 - 6 - 2012

References

• Rocznik demograficzny 2010.
• Pogorzelski R, Wołoszko T, Małek AK i wsp.: Zapotrzebowanie na doraźną pomoc z zakresu chirurgii naczyniowej wśród chorych po osiemdziesiątym roku życia w doświadczeniu jedoośrodkowym - analiza porównawcza uzyskanych wyników. Pol Przegl Chir 2010; 82(5): 267-71.
• Polanczyk CA, Marcantonio E, Goldman L et al.: Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med 2001; 134: 637-43.
• Bufalari A, Ferri M, Cao P et al.: Surgical care in octogenarians. Br J Surg 1996; 83: 1783-87.
• Weintraub WS, Craver JM, Cohen CL et al.: Influence of age on results of coronary artery surgery. Circulation 1984; 3: 226-35.
• Dunlop WE, Rosenblood L, Lawrason L et al.: Effects of age and severity of illness on outcome and length of stay in geriatric surgical patients. Am J Surg 1993; 165: 577-80.
• Bliss R, Patel N, Guinea A et al.: Age is no contraindication to thyroid surgery. Age and ageing 1999; 28: 363-66.
• Ong ES, Alassas M, Dunn KB et al.: Colorectal cancer surgery in the elderly: acceptable morbidity? Am J Surg 2008; 195(3): 344-48.
• Blansfield JA, Clark SC, Hofmann MT et al.: Alimentary tract surgery in the nonagenarian: elective vs. emergent operations. J Gastrointest Surg 2004; 8(5): 539-42.[PubMed][Crossref]
• Kim HO, Yun JW, Shin JH et al.: Outcome of laparoscopic cholecystectomy is not influenced by chronological age in the elderly. World J Gastroenterol 2009; 15(6): 722-26.[Crossref][PubMed][WoS]
• Smith KM, Lamy A, Arthur HM et al.: Outcomes and costs of coronary artery bypass grafting: Comparison between octogenarians and septuagenarians at atertiary care centre. Can Med Assoc J 2001; 165: 759-64.
• Katz NM, Chase GA: Risks of cardiac operations for elderly patients: Reduction of the age factor. Ann Thorac Surg 1997; 63: 1309-14.
• Williams SB, Greenspon J, Young HA et al.: Small bowel obstruction: conservative vs. surgical management. Dis Colon Rectum 2005; 48(6): 1140-46.[PubMed][WoS][Crossref]
• Tarnowski W, Kamiński P, Bielecki K: Wyniki leczenia raka jelita grubego u chorych w wieku powyżej 80. roku życia. Pol Przegl Chir 2010; 82(7): 720-32.
• Chow LW, Gertsch P, Poon RT et al.: Risk factors for rebleeding and death from peptic ulcer in the very elderly. Br J Surg 1998; 85(1): 121-24.
• Kozieł D, Matykiewicz J, Głuszek S: Krwawienie z przewodu pokarmowego u chorych powyżej 85. roku życia. Pol Przegl Chir 2011; 83(11): 1122-35.

Identifiers

DOI

10.2478/v10035-012-0028-x