title: In-Hospital Mortality in a 4-Year Cohort Study of 3,093,254 Operations in Seniors.
abstract: BACKGROUND
  Surgery-related mortality depends on a number of factors including the type of surgical procedure, quality of healthcare, co-morbidities, and age of patient. The objective of the study was to assess the in-hospital mortality in the elderly undergoing surgical treatment.
  
  
  METHODS
  This was a national data-based retrospective cohort study. Data were extracted from the National Health Fund, a public organization financing medical procedures in Poland. Adult citizens who underwent 9,344,384 surgical interventions (including 3,093,254 cases in seniors who were above 65 years old) between 2009 and 2012 were included in this study. Overall, surgery type-dependent, age-stratified in-hospital mortality related to surgery was assessed.
  
  
  RESULTS
  Overall in-hospital surgery-related mortality rate in seniors was stable (approximately 2 % annually, P for trend = 0.104). It doubled with each successive decade of life (1.2, 2.3, 5.6, and 13 % in 65-74, 75-84, 85-94 and ≥ 95 years old groups, respectively, in 2012). In ≥ 75-year-old mortality exceeded 10 % only after neurological surgeries, in ≥ 85-year-old after neurological, vascular, gastrointestinal, and endocrinological surgeries, and in ≥ 95-year-old also after heart and circulation, bones and muscles, liver, pancreas, and spleen operations. However, even in the oldest individuals it was low after genitourinary, female genital tract, head and neck, and eye surgeries.
  
  
  CONCLUSIONS
  The overall rate of in-hospital mortality after surgery, although increasing with age, is rather low up to the ninth decade of life. Whereas some surgeries pose a significant risk, others may be relatively safe even in the oldest subjects.
authors.affiliation: Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, Marymoncka 99/103, 01-813, Warsaw, Poland.|Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawinskiego 5, 02-106, Warsaw, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Puzianowska-Kuznicka
authors.affiliation: Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSW, Woloska 137, 02-507, Warsaw, Poland. m_walicka@wp.pl.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Walicka
authors.affiliation: National Health Fund, Grojecka 186, 02-390, Warsaw, Poland.
authors.forename: Boguslawa
authors.initials: B
authors.lastname: Osinska
authors.affiliation: National Health Fund, Grojecka 186, 02-390, Warsaw, Poland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rutkowski
authors.affiliation: Department of Applied Statistics and Bioinformatics, Warsaw University of Life Sciences, Nowoursynowska 166, 02-787, Warsaw, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Gozdowski
authors.affiliation: Department of Pharmacoeconomics, Medical University of Warsaw, Zwirki i Wigury 81, 02-091, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Czech
authors.affiliation: Department of Gastrointestinal and Transplantological Surgery, Central Clinical Hospital MSW, Woloska 137, 02-507, Warsaw, Poland.|Department of Surgical Research and Transplantology, Mossakowski Medical Research Centre, Pawinskiego 5, 02-106, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Durlik
authors.affiliation: Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawinskiego 5, 02-106, Warsaw, Poland.|Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSW, Woloska 137, 02-507, Warsaw, Poland.
authors.forename: Edward
authors.initials: E
authors.lastname: Franek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000401:mortality* / Q000706:statistics & numerical data*; D013997:Time Factors