Abdominal surgery in nonagenarians: short-term results.
OBJECTIVE
To determine the short-term results of abdominal surgery in nonagenarians.


METHODS
Retrospective analyses of 193 patients aged 90 and older operated on for abdominal complaints during a 15-year period (1990-2004) in a 500-bed tertiary care institutional hospital and 100-bed rural institutional hospital in Spain. The factors analyzed included the following: perioperative risk, diagnosis, operative procedures, timing of operation (elective or emergency), morbidity, mortality, and length of hospital stay.


RESULTS
The most common diagnoses were hernia in 69 cases, colorectal cancer in 39, and biliary lithiasis in 24. One hundred and thirty-seven patients (71%) were operated on on an emergency basis. Forty-seven patients died (24%), with mortality rates of 9% (5/56) and 31% (42/137) respectively, for elective and emergency surgery. None of the 15 patients classified as grade I according to the criteria of the American Society of Anesthesiologists (ASA) died and only 3 out of 63 (5%) died who were ASA grade II. Eighty patients (41%) had postoperative complications. Local morbidity was 16% (n = 30), and systemic morbidity was 30% (n = 58).


CONCLUSIONS
Our results support the notion that elective and acute abdominal surgery in nonagenarians can be performed with acceptable rates of mortality and morbidity. Mortality for surgery in nonagenarians is strongly related to the perianesthetic risk (ASA grade), emergency operation, and seriousness of the disease in question.
Arenal
Juan J
JJ
Department of Surgery, University Hospital Río Hortega, Valladolid, Spain.
de Teresa
Gustavo
G
Tinoco
Claudia
C
Toledano
Miguel
M
Said
Awwad
A
D000367:Age Factors; D000369:Aged, 80 and over; D004066:Digestive System Diseases / Q000453:epidemiology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome