title: The outcomes of the elderly in acute care general surgery.
abstract: BACKGROUND
  Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old.
  
  
  METHODS
  A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student's t test for continuous variables and Fisher's exact test for categorical variables using STATA 12 (College Station, TX, USA).
  
  
  RESULTS
  We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (p < 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (p < 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (p = 0.05), increased postoperative complications (p = 0.002), admission to the ICU (p = 0.002), and were more likely to receive a non-operative procedure (p = 0.003). No difference was found (p = NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition.
  
  
  CONCLUSIONS
  Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. etienne.st-louis@mail.mcgill.ca.
authors.forename: E
authors.initials: E
authors.lastname: St-Louis
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. monisha.sudarshan@mail.mcgill.ca.
authors.forename: M
authors.initials: M
authors.lastname: Sudarshan
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. dr.safsaf@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Al-Habboubi
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. mo.elhusseini@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: El-Husseini Hassan
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. dan.deckelbaum@mcgill.ca.
authors.forename: D L
authors.initials: DL
authors.lastname: Deckelbaum
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. tarek.razek@mcgill.ca.
authors.forename: T S
authors.initials: TS
authors.lastname: Razek
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. liane.feldman@mcgill.ca.
authors.forename: L S
authors.initials: LS
authors.lastname: Feldman
authors.affiliation: Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. kosar.khwaja@mcgill.ca.
authors.forename: K
authors.initials: K
authors.lastname: Khwaja
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004630:Emergencies; D005260:Female; D013502:General Surgery; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative; D055815:Young Adult
keywords: Age; Elderly; Emergency general surgery; Octogenarian; Outcomes