Thoracic surgery in the elderly--co-morbidity is the limit.
A retrospective chart review was performed in 242 consecutive patients aged 65 years or older who were treated in an academic surgical centre between January 2004 and July 2007. A total of 249 thoracic procedures were performed in 242 patients, of whom 143 were men and 99 women with a mean age of 69.9 years (range 65-92). Overall operative mortality was 2.4%, rising to 26.4% in emergency patients. Negative predictors for perioperative mortality were: American Society of Anesthesiology (ASA) class 4, pre-existing kidney failure, leucocytosis, low haemoglobin, elevated C-reactive protein, diabetes mellitus and emergency surgery. In addition, the risk of major and minor complications resulting in a prolonged hospital stay was increased in emergency patients, patients with multiple co-morbidities and ASA class 3 or 4. Appropriate thoracic surgery can be offered to the elderly with an acceptable level of perioperative morbidity and mortality. Regardless of age, a high degree of co-morbidity or emergency surgery are the main risk factors for perioperative mortality and/or prolonged hospital stay.
Limmer
Stefan
S
Department of Surgery, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Stefan.limmer@uk-sh.de
Hauenschild
Lena
L
Eckmann
Christian
C
Czymek
Ralf
R
Schmidt
Henriette
H
Bruch
Hans-Peter
HP
Kujath
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000401:mortality; D004638:Emergency Treatment / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged; D006454:Hemoglobins / Q000032:analysis; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D007964:Leukocytosis / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D051437:Renal Insufficiency / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019616:Thoracic Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D016896:Treatment Outcome
D015415:Biomarkers; D006454:Hemoglobins; D002097:C-Reactive Protein