Urological surgery in patients aged 80 years and older: a 30-year retrospective clinical study.
OBJECTIVE
To investigate changes in the management of cases over time, we undertook a retrospective analysis of urological surgeries carried out in patients aged 80 years and older in a single institution over the last 30 years.


METHODS
Between 1975 and 2004, 402 patients aged 80 years and older underwent 412 surgeries in our department. We reviewed the clinical records and analyzed changes in clinical data over time. We evaluated the observed comorbidities and postoperative complications in selected patients for whom complete clinical records were available. We then identified risk factors for postoperative complications by means of multiple logistic regression analysis.


RESULTS
The number of surgeries carried out in patients aged 80 years and older increased every 5 years. Over time, the number of endourological and laparoscopic surgeries increased. Of 255 patients, 225 (88.3%) had at least one comorbidity, and 51 patients had postoperative complications. The number of observed comorbidities, such as cardiovascular disorder, central nervous system disorder, and diabetes mellitus, increased over the most recent 10-year period. However, there were no differences in postoperative complications over time. Male sex and open surgery were found to be independent risk factors for postoperative complications.


CONCLUSIONS
Although elderly patients had various comorbidities, the postoperative morbidity rate was acceptable in our selected cases. This study may provide useful detailed information for patients 80 years and older who will undergo urological surgery.
Takao
Tetsuya
T
Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Tsujimura
Akira
A
Kiuchi
Hiroshi
H
Komori
Kazuhiko
K
Fujita
Kazutoshi
K
Miyagawa
Yasushi
Y
Takada
Shingo
S
Nonomura
Norio
N
Okuyama
Akihiko
A
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*