title: An analysis of surgical outcomes in patients aged 80 years and older.
abstract: OBJECTIVE
  Elderly patients (aged ≥ 80 years) undergo an increasing number of operations. Elderly patients undergoing operations usually develop more postoperative complications and have poorer outcomes. The aim of this study is to identify the relative importance between preoperative and intraoperative variables to predict adverse postoperative outcomes in these patients.
  
  
  METHODS
  We retrospectively analyzed the records of 404 patients (aged ≥ 80 years and underwent a noncardiac surgery) collected from the quality assurance database in our department. We reviewed the patients' preoperative and intraoperative variables as well as postoperative complications and outcomes. Odds ratios of risk factors were then calculated by univariate and multivariate analyses. In addition, hazard ratios of incidence of discharge and mortality rates were analyzed.
  
  
  RESULTS
  Overall, 26.4% of patients developed one or more postoperative complications, and the in-hospital mortality rate was 6.7%. The majority of these patients had pre-existing cardiovascular disorders such as hypertension (47.5%). Respiratory complication was the most common postoperative complication (12.9%). Multivariate analysis showed male sex, anesthesia method, and colloid infusion were risk factors for increased respiratory complication. Our results showed that patients who developed different kinds of postoperative complications had a different level of risks associated with prolonged hospital stay and mortality.
  
  
  CONCLUSIONS
  Patients over the age of 80 years, of male sex, under general anesthesia, and receiving colloid infusion were at a higher risk of developing respiratory complications. Postoperative respiratory complications occurred in most of the geriatric surgical patients. Efforts to improve the surgical outcomes must include measures to minimize in-hospital complications. Detailed evaluation and better communicating the aforementioned risk factors to these patients are suggested for improving anesthesia quality and surgical outcomes.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Jui-Ying
authors.initials: JY
authors.lastname: Chung
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Wan-Yu
authors.initials: WY
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Ta-Wei
authors.initials: TW
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Jyun-Ruei
authors.initials: JR
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Min-Wen
authors.initials: MW
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC. Electronic address: chou51chou51@yahoo.com.tw.
authors.forename: An-Hsun
authors.initials: AH
authors.lastname: Chou
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
keywords: elderly; outcomes; surgery