title: Indications for emergency surgery for perforated diverticulitis in elderly Japanese patients ≥80 years of age.
abstract: OBJECTIVE
  Perforated diverticulitis (PD) remains a serious acute abdominal condition. The aim of this study was to evaluate indications for emergency surgery in patients ≥80 years of age with PD.
  
  
  METHODS
  Twenty patients ≥80 years of age and 28 younger patients who underwent emergency surgery for PD from January 2002 to December 2011 were studied. The demographics and postoperative outcomes were compared.
  
  
  RESULTS
  The preoperative characteristics, mortality rate, and postoperative complications were similar between these two groups. All seven patients ≥80 years of age with an American Society of Anesthesiologists (ASA) score of 2 survived after surgery. All five patients with a Mannheim peritonitis index (MPI) score of ≥26 in the elderly group died after surgery. There were significant associations between the mortality, the MPI and ASA score in patients ≥80 years of age.
  
  
  CONCLUSIONS
  Best supportive care may be an alternative for patients ≥80 years of age with PD, an ASA score of ≥3 or an MPI score of ≥26.
authors: Department of Surgery, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan, gottingottin2000@yahoo.co.jp.
authors: Go
authors: G
authors: Anegawa
authors: Yuichiro
authors: Y
authors: Nakashima
authors: Takanobu
authors: T
authors: Masuda
authors: Rinshun
authors: R
authors: Shimabukuro
authors: Ikuo
authors: I
authors: Takahashi
authors: Takashi
authors: T
authors: Nishizaki
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D044466:Asian People; D013505:Digestive System Surgical Procedures / Q000401:mortality; D004239:Diverticulitis, Colonic / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D004638:Emergency Treatment / Q000401:mortality; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007416:Intestinal Perforation / Q000401:mortality / Q000601:surgery*; D008297:Male; D010538:Peritonitis / Q000401:mortality; D012720:Severity of Illness Index