title: Renal insufficiency predicts mortality in geriatric patients undergoing emergent general surgery.
abstract: Clinical predictors of perioperative mortality in geriatric patients undergoing emergent general surgery have not been well described. The purpose of this study was to determine the incidence of postoperative morbidity and mortality in geriatric patients and factors associated with  mortality. A retrospective review of patients 65 years of age or older undergoing emergent general surgery at a public teaching hospital was performed over a 7-year period. Data collected included demographics, comorbidities, laboratory studies, perioperative morbidities, and mortality. Descriptive  statistics and predictors of morbidity and mortality are described. The mean age was 74 years. Indications for surgery included small bowel obstruction (24%), diverticulitis (20%), perforated viscous (16%), and large bowel obstruction (9%). The overall complication rate was 41 per cent with  six cardiac complications (14%) and seven perioperative (16%) deaths. Mean admission serum creatinine was significantly higher in patients who died (3.6 vs 1.5 mg/dL, P = 0.004). Mortality for patients with an admission serum creatinine greater than 2.0 mg/dL was 42 per cent  (5 of 12) compared with 3 per cent (2 of 32) for those 2.0 mg/dL or less (OR, 10.7; CI, 1.7 to 67; P = 0.01). Morbidity and mortality in geriatric patients undergoing emergency surgery remains high with the most significant predictor of mortality being the presence of renal insufficiency  on admission.
authors: Harbor-UCLA Medical Center, Torrance, California 90509, USA.
authors: Arezou
authors: A
authors: Yaghoubian
authors: Phillip
authors: P
authors: Ge
authors: Amy
authors: A
authors: Tolan
authors: Guy
authors: G
authors: Saltmarsh
authors: Amy H
authors: AH
authors: Kaji
authors: Angela L
authors: AL
authors: Neville
authors: Scott
authors: S
authors: Bricker
authors: Christian
authors: C
authors: De Virgilio
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D004630:Emergencies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology; D013514:Surgical Procedures, Operative; D015996:Survival Rate / Q000639:trends; D013997:Time Factors