Emergency abdominal surgery in the elderly.
We reviewed 201 consecutive patients aged over 65 years who were operated on for acute abdomen during the period 1986-89. Emergency procedures were most commonly performed on the biliary tract (24%), the appendix (20%), bowel (15%) and abdominal wall (12%). The postoperative morbidity was 26%, and the mortality rate of 22% was related most commonly to mesenterial thrombosis and intestinal obstruction. In fatal cases, 44% of the patients were over 80 years old and 64% were placed into the ASA classes IV-V. Eighty-four patients (42%) underwent postoperative intensive care, and 22 re-operations (9.0%) were performed. The mean hospital stay was 12 days and 70% of patients returned home after surgery. In conclusion, the outcome of emergency abdominal surgery in patients under 80 years of age and with no serious co-existing diseases has improved. Very old patients in ASA classes 4-5 still have a poor outcome.
Kettunen
J
J
Department of Surgery, Kuopio University Hospital, Finland.
Paajanen
H
H
Kostiainen
S
S
D000006:Abdomen, Acute / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors