Outcome of surgery and anesthesia in patients 80 years of age and older.
We studied retrospectively the outcome of surgery and anesthesia in 294 patients aged 80 and older who underwent 362 surgical procedures. Of these, 52 cases (14.4%) were admitted to intensive care unit (ICU) post-operatively. The 48-hour, 48-hour-to-30-day and overall mortality rates were 0.8%, 3.8% and 5.2% respectively. ICU. admission and mortality rate were closely associated with the ASA physical status classification. The overall mortality rates were 1.3%, 5.7% and 27% in class II, III and IV respectively. The respective ICU admission rates were 3%, 20% and 56%. ICU admission rate and mortality rate were 42.5% and 13.8% in emergency surgery vs. 5.8% and 2.5% in elective surgery. Patients with 3 or more co-existing diseases had the mortality rate of 23% and the rates of ICU admission and mortality for those with 3 or more peri-operative complications were 22% and 16% respectively vs. 11% and 4% for those with 2 or less peri-operative complications. General surgery was associated with the highest mortality rate (15%) than other type of procedures. 22 of 74 cases who underwent intra-abdominal surgery required controlled ventilation for more than 24 hours post-operatively. 59% (13 cases) of such cases could not weaned successfully from ventilators and died subsequently. Only 2.5% (7 cases) of cases who underwent extra-pleural and extra-peritoneal procedures required controlled ventilation for more than 24 hours post-operatively. Of these, 2 died subsequently. For comparison, the study were artificially divided into two phases, each of three years long: they were the period from 1986-1988 and the period from 1989-1992.(ABSTRACT TRUNCATED AT 250 WORDS)
Cheng
K W
KW
Department of Anesthesiology, Chang Gung Memorial Hospital, Kaohsing.
Wang
C H
CH
Ho
R T
RT
Jawan
B
B
Lee
J H
JH
D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000401:mortality*