Emergency surgery in the elderly: a retrospective observational study.
We conducted a retrospective observational study in a regional hospital on patients aged 80 years or over undergoing emergency procedures. We included 202 emergency procedures performed on 178 patients over 185 separate admissions. The aim was to obtain a 'snapshot' of the risks of emergency surgery in the elderly and to analyse functional status both as a risk factor and as an outcome in this patient group. The most common complications were infective (21% of patients), cardiovascular (18%) and neurological (18%). Overall mortality was 9%. Increasing age, higher American Society of Anesthesiologists physical status score and poorer pre-admission functional status appeared to be associated with increased complications and mortality. Although two-thirds of both functionally independent and partially dependent patients were discharged at their original level of function, 28% of partially dependent patients required discharge to a high-level care nursing home, whereas only 5% of the initially independent patients had this poor outcome. Improvement in our ability to stratify risk in this enlarging patient group should help improve our clinical decision-making, which may have benefits both for patients and resource allocation.
Department of Anaesthetics, Launceston General Hospital, Launceston, Tasmania, Australia.
Mark
M
Alcock
Colin R
CR
Chilvers
D000367:Age Factors; D000369:Aged, 80 and over; D004630:Emergencies; D006304:Health Status; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome