title: Changes in hospitalisation and surgical procedures among the oldest-old: a follow-up study of the entire Danish 1895 and 1905 cohorts from ages 85 to 99 years.
abstract: OBJECTIVE
  to examine whether the Danish 1905 cohort members had more active hospital treatment than the 1895 cohort members from ages 85 to 99 years and whether it results in higher in-hospital and post-operative mortality.
  
  
  METHODS
  in the present register-based follow-up study the complete Danish birth cohorts born in 1895 (n = 12,326) and 1905 (n = 15,477) alive and residing in Denmark at the age of 85 were followed from ages 85 to 99 years with regard to hospitalisations and all-cause and cause-specific surgical procedures, as well as in-hospital and post-operative mortality.
  
  
  RESULTS
  the 1905 cohort members had more frequent hospital admissions and operations, but they had a shorter length of hospital stay than the 1895 cohort at all ages from 85 to 99 years. The increase in primary prosthetic replacements of hip joint was observed even within the 1895 cohort: no patients were operated at ages 85-89 years versus 2.2-3.6% at ages 95-99 years. Despite increased hospitalisation and operation rates, there was no increase in post-operative and in-hospital mortality rates in the 1905 cohort. These patterns were similar among men and women.
  
  
  CONCLUSIONS
  the observed patterns are compatible with more active treatment of the recent cohorts of old-aged persons and reduced age inequalities in the Danish healthcare system. No increase in post-operative mortality suggests that the selection of older patients eligible for a surgical treatment is likely to be based on the health status of old-aged persons and the safety of surgical procedures rather than chronological age.
authors.affiliation: Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9B, Odense, Denmark. aoksuzyan@health.sdu.dk
authors.forename: Anna
authors.initials: A
authors.lastname: Oksuzyan
authors.forename: Bernard
authors.initials: B
authors.lastname: Jeune
authors.forename: Knud
authors.initials: K
authors.lastname: Juel
authors.forename: James W
authors.initials: JW
authors.lastname: Vaupel
authors.forename: Kaare
authors.initials: K
authors.lastname: Christensen
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D000375:Aging; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged / Q000639:trends*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000401:mortality / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Denmark; cohort comparison; hospitalisation; in-hospital mortality; old age; older people; post-operative mortality; register study; surgical procedure