title: The prognostic role of comorbidities in older patients qualified for emergency abdominal surgery.
abstract: Until now, the literature about the influence of specific comorbid conditions on outcome of emergency abdominal surgery in polish elderly patients is scars. The aim of the study was to determine the prognostic role of comorbidities in patients qualified for emergency abdominal surgery.
  
  
  METHODS
  One hundred and eighty four consecutive patients(98 female and 86 male). 65 years of age were prospectively enrolled. The mean age was 76.9 ± 5.8 (range 65-100) years old.
  
  
  RESULTS
  Only 16% of patients did not have any preoperative comorbidity. The 30-day mortality was 24.5% (45 patients). The 30-day morbidity was experienced by the 58.7% (108 patients), including 40 patients (21.7%) with minor complications and 68 patients (37%) with major complications, according to the Clavien-Dindo complications scale. The dysrhythmia (odds ratio 1.6, 95% CI 1.2-2.6, p=0.02), vascular disease (odds ratio 2.1, 95% CI 1.4- 3.1, p=0.02) and renal disease (odds ratio 1.4, 95% CI 1.2-2.8, p=0.01) were independent risk factors of 30-day morbidity. The vascular disease was also the independent risk factor of 30-day postoperative death in the multivariate regression analysis (odds ratio 1.9, 95% CI 1.3-2.8, p=0.001).
  
  
  CONCLUSIONS
  Preoperative comorbidities are common among elderly patients qualified for emergency abdominal surgery. However, only some of them (the dysrhythmia, the vascular disease and the renal disease) are independent risk factors of postoperative adverse outcomes. Therefore, number of comorbidies alone should not be the reason for a limited treatment.
authors: Jakub
authors: J
authors: Kenig
authors: Piotr
authors: P
authors: Richter
authors: Urszula
authors: U
authors: Olszewska
authors: Beata
authors: B
authors: Żychiewicz
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000453:epidemiology; D015897:Comorbidity; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D014652:Vascular Diseases / Q000150:complications* / Q000453:epidemiology