[Risk factors in elderly surgical patients. A prospective study].
250 patients aged 65 and more were operated in a general surgical unit and were studied prospectively on admission. 16 parameters have been studied, trying to determine the factors which might induce a risk of post-operative complications. These complications, minor or major, were found in 25% of the cases (62) of whom 11 (4%) died. As expected, this study shows that with the increase in the importance or the number of unfavorable factors, the complication rate rises. The statistical analysis shows that some factors are of low significance, such as the degree of emergency of the surgical operation or hyperglycemia. Other factors are highly significant for predicting complications: increased dependence, bad mental score, anemia, increased prothrombin time, hyponatremia or the presence of other pathological states than those studied. The importance and the type of the surgical operation, particularly bone traumatology, vascular surgery, thoracic and visceral surgery involve a high rate of post-operative complications. The same is true when malnutrition or hypoalbuminemia are present. Advancing age represents per se an augmentation of these risks, because the elderly patients are not able to meet the increased metabolic demand. This loss of reserve capacity is the most important factor that decreases the elderly patient's ability to tolerate operations. The risk factors mentioned above are particularly important because some pathological states can be corrected, and some other preventive measures can be taken before surgery, as far as one is not dealing with emergency.
Tschantz
P
P
Service de chirurgie, Hôpital des Cadolles, Neuchâtel.
Tuchschmid
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003955:Diagnostic Tests, Routine; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D011446:Prospective Studies; D018570:Risk Assessment; D013557:Switzerland