title: Patients aged 80 and older undergoing orthopedic or urologic surgery: a prospective study focusing on perioperative morbidity and mortality.
abstract: BACKGROUND
  The population is progressively aging and an increasing number of elderly patients face surgical treatment.
  
  
  OBJECTIVE
  The current study was designed to examine the perioperative morbidity and mortality of elderly patients undergoing orthopedic or urologic surgery and look for predictors for adverse outcome.
  
  
  METHODS
  This is a prospective study of elderly patients, 80 years of age and older, who underwent elective or emergent orthopedic or urologic surgery in our institution during a 5-month period. Data were collected on age, gender, chronic diseases, number of regular medications, whether or not the patient was bedridden before surgery, American Society of Anesthesiologists (ASA) class, type of surgery and anesthesia, duration of hospitalization, and 30-day postoperative morbidity and mortality. We studied correlations between pre- and intraoperative parameters and postoperative complications.
  
  
  RESULTS
  During the study period, 39 patients underwent urologic surgery and 147 patients underwent orthopedic surgery. Age ranged from 80 to 98 years (85 +/- 4.2 years, mean +/- SD). One patient had an intraoperative complication, 5 patients had postoperative complications within 1 day of surgery, and 23 had complications within 1 month of surgery. Five (2.7%) patients, all of whom were operated urgently, died after surgery. Postoperative complications correlated significantly to poor ASA class (p = 0.01), urgency of the procedure (p = 0.03), and extent (p = 0.02) and duration (p = 0.01) of surgery. No significant correlation was found between outcome and any other pre- or intraoperative factors.
  
  
  CONCLUSIONS
  Elderly surgical patients with poor ASA class or following urgent, extensive or long surgery are at a higher risk for postoperative morbidity and mortality, mandating special perioperative care.
authors.affiliation: Department of Orthopedic Surgery B, Rambam Health Care Campus and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Peled
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Keren
authors.forename: Sarel
authors.initials: S
authors.lastname: Halachmi
authors.forename: Michael
authors.initials: M
authors.lastname: Soudry
authors.forename: Chaim
authors.initials: C
authors.lastname: Zinman
authors.forename: Yeshayahu
authors.initials: Y
authors.lastname: Kats
authors.forename: Michal
authors.initials: M
authors.lastname: Barak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000401:mortality*; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000401:mortality