title: Major liver resection in elderly patients: a multi-institutional analysis.
abstract: BACKGROUND
  Because of the aging United States population, increase in overall life expectancy, and rising incidence of hepatobiliary tumors, more elderly patients are considered for hepatic resection. The objective of this study was to assess the influence of age on postoperative outcomes after major hepatectomy among a contemporary cohort from 2 high volume centers.
  
  
  METHODS
  Demographics, diagnoses, surgical treatments, and postoperative outcomes of patients who underwent major hepatic resection were reviewed.
  
  
  RESULTS
  There were 856 patients who underwent major hepatectomy (resection of 3 or more segments) from 2002 to 2009. Postoperative mortality and morbidity occurred in 53 (6.2%) and 403 (47.1%) patients, respectively. Increasing age was independently associated with postoperative mortality (p = 0.0345). Each 1-year and 10-year increase in age resulted in an odds ratio of mortality after major hepatic resection of 1.036 (95% CI [1.003-1.071]) and 1.426 (95% CI [1.026-1.982]), respectively. This relationship was independent of American Society of Anesthesiology (ASA) score. Increasing age was associated with postoperative sepsis (p = 0.0224, odds ratio for each year 1.025 [range 1.003 to 1.048]) after major hepatic resection, but not overall postoperative morbidity.
  
  
  CONCLUSIONS
  In the contemporary era, increasing age is independently associated with postoperative mortality after major hepatic resection at high volume academic centers.
authors: Department of Surgery, Duke University Medical Center, Durham, NC, USA. reddysk@upmc.edu
authors: Srinevas K
authors: SK
authors: Reddy
authors: Andrew S
authors: AS
authors: Barbas
authors: Ryan S
authors: RS
authors: Turley
authors: T Clark
authors: TC
authors: Gamblin
authors: David A
authors: DA
authors: Geller
authors: J Wallis
authors: JW
authors: Marsh
authors: Allan
authors: A
authors: Tsung
authors: Bryan M
authors: BM
authors: Clary
authors: Sandhya
authors: S
authors: Lagoo-Deenadayalan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome