[Abdominal interventions in advanced age: risk factors and fatal outcome].
1026 patients of more than 65 of age who underwent abdominal surgical treatment were retrospectively investigated with respect to pre-operative riskfactors, post-operative complications and mortality. Mortality after emergency intervention was with 16.54% about 3 times as high as after elective surgery (5.54%). 25.4% of all patients had no coexisting diseases. Preexisting diseases were cardiovascular (45.9%), hypertension (28.7%), pulmonary diseases (19.4%) and diabetes mellitus (16.6%). 37.32% of all patients showed one accompanying disease, 23.98% two, 10.4% three and 4 or more were described with 3.31%. The average number of riskfactors was 1.1 for patients aged 65-69 years, 1.34 for patients aged 70-74 years, 1.52 for those aged 75-79 years and 1.41 for patients over 80 years. There was a significant increase of mortality with rising numbers of riskfactors (p < 0.01). In 50.58% of all patients no post-operative complications developed. Cardiovascular, pulmonary and myocardial complications were the leading complications, occuring in 18.52%, 16.8% and 13.74% of patients, being followed by cerebral-vascular (5.63%) and renal (4.09%) complications. The incidence of medical complications was significantly higher after emergency than after elective surgery (p < 0.01). At least 4 and more complications occurred after 2.56% of elective interventions but after 20.24% of emergency surgery. A significant increase of postoperative complications has been observed with increasing extent of anaesthesia (p < 0.01). Moreover, the incidence of complications increased significantly with the amount of preoperative coexisting diseases (p < 0.01).
Steinau
G
G
Chirurgische Klinik, Rheinisch Westfälische Technische Hochschule, Aachen.
Haese
C
C
Schumpelick
V
V
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate