title: Perioperative morbidity and mortality in elderly gynecological oncological patients (>/= 70 Years) by the American Society of Anesthesiologists physical status classes.
abstract: BACKGROUND
  We evaluated the morbidity and mortality associated with American Society of Anesthesiologists (ASA) classes III and IV versus ASA classes I and II in elderly women (>/= 70 years) undergoing gynecological oncological surgery.
  
  
  METHODS
  From 1986 to 2000, we retrospectively collected patients >/= 70 years of age undergoing oncological gynecological surgery. The study population consisted of 121 ASA class III and IV patients. The control group consisted of the same number of patients with ASA classes I and II, and these were matched to study patients (1:1) by clinical and surgical data. The morbidity and mortality of patients with ASA status III and IV were analyzed before and after 1992.
  
  
  RESULTS
  In ASA class III and IV patients, compared with ASA class I and II, a higher rate of severe morbidity (P =.000) occurred, whereas the median postoperative stay was similar (8 days). No differences between patients with ASA class III and IV and ASA class I and II for median operative time, transfusion rate, or median blood loss were found. Mortality was 3% in ASA classes III and IV.
  
  
  CONCLUSIONS
  Our study suggests that surgery in elderly gynecological oncological patients aged >/= 70 years with ASA class III or IV results in an acceptable perioperative morbidity and mortality rate.
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart of Rome, Rome, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Giannice
authors.forename: Elvira
authors.initials: E
authors.lastname: Foti
authors.forename: Antonella
authors.initials: A
authors.lastname: Poerio
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Marana
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mancuso
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003657:Decision Making; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000401:mortality; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D018709:Statistics, Nonparametric