title: Surgical outcomes in the elderly with inflammatory bowel disease are similar to those in the younger population.
abstract: BACKGROUND
  Inflammatory bowel disease (IBD) has a bimodal distribution with approximately 15 % of patients manifesting after age 65. Previous reports suggest an increased risk of surgical complications in the elderly.
  
  
  OBJECTIVE
  To compare surgical outcomes in elderly IBD patients (≥ 65 years at the time of surgery) to matched younger IBD cohorts.
  
  
  METHODS
  This was a retrospective cohort study at a single academic center of patients who underwent surgery for IBD. Forty-two elderly patients (≥ 65 years) were matched at least 1:1 (median 1:5) to patients in each of three control groups [18-35 years (n = 71); 36-49 years (n = 62); 50-64 years (n = 58)] according to gender, disease type/location, and type of surgery. Postoperative complications were compared. Patient characteristics were used in multivariate risk models. Analysis was performed using ordinary logistic regression.
  
  
  RESULTS
  Twenty ileal or ileocolonic resections, 12 partial or total colectomies, four stricturoplasties, and six laparoscopic partial or total colectomies were performed in the elderly group. The post-operative complication rate was not statistically different between the elderly and younger cohorts (38 % vs. 39 % vs. 40 % vs. 48 % in the 18-35, 36-49, 50-64, and ≥ 65 years groups, respectively, p = 0.26). The only significant risk factors for complication were Charlson comorbidity index (p = 0.0002), preoperative hemoglobin (p = 0.0065), total parenteral nutrition use (p = 0.024), and failed medical therapy (as the indication for surgery) (p = <0.0001).
  
  
  CONCLUSIONS
  The surgical complication rate among elderly and younger IBD patients was similar. Advanced age by itself should not be considered a risk factor for adverse operative outcome.
authors.affiliation: Department of Medicine, Kaiser Permanente Medical Center, Santa Clara, CA, USA.
authors.forename: Marita C
authors.initials: MC
authors.lastname: Bautista
authors.forename: Mary F
authors.initials: MF
authors.lastname: Otterson
authors.forename: Yelena
authors.initials: Y
authors.lastname: Zadvornova
authors.forename: Amar S
authors.initials: AS
authors.lastname: Naik
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Nanda
authors.initials: N
authors.lastname: Venu
authors.forename: Lilani P
authors.initials: LP
authors.lastname: Perera
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult