A simple novel model to predict hospital mortality, surgical site infection, and pneumonia in elderly patients undergoing operation.
OBJECTIVE
Predicting models of operative morbidity and mortality in the geriatric population are important in the prevention of adverse surgical outcomes.


METHODS
A retrospective review of medical records was performed for patients over 80 years of age who underwent gastrointestinal surgery from 1998 to 2008.


RESULTS
215 patients were identified with a mean age of 83.7 years. Overall morbidity and mortality rates were 48.8 and 14.4%, respectively. Multivariate logistic regression analysis revealed that serum albumin levels [odds ratio (OR) = 0.367, p = 0.0267], postoperative pneumonia (OR = 3.471, p = 0.0101), hollow organ perforation or anastomosis combined with leakage (OR = 7.600, p = 0.0126), and preoperative systemic inflammatory response syndrome (OR = 3.186, p = 0.0323) were significant predictors of hospital mortality. Moreover, albumin (OR = 0.270, p = 0.0002) and physical disability (OR = 3.802, p = 0.0009) were significant predictors of postoperative pneumonia, and albumin (OR = 0.491, p = 0.0212) and enterotomy (OR = 3.335, p = 0.0208) were significant predictors of surgical site infections.


CONCLUSIONS
This study provides novel predicting models to identify the elderly surgical patients at high risk, who should receive more intensive preventive and perioperative care.
Huang
Ting-Shuo
TS
Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University, Keelung Branch, Keelung, Taiwan, ROC.
Hu
Fu-Chang
FC
Fan
Chung-Wei
CW
Lee
Chun-Hui
CH
Jwo
Shyh-Chuan
SC
Chen
Huang-Yang
HY
D000005:Abdomen / Q000601:surgery; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000401:mortality; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D015233:Models, Statistical; D011014:Pneumonia / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D012044:Regression Analysis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D018746:Systemic Inflammatory Response Syndrome / Q000401:mortality
D012709:Serum Albumin