title: Liver resection in the elderly: A retrospective cohort study of 460 patients - Feasible and safe.
abstract: BACKGROUND
  The aim of this study was to determine the influence of age on the early postoperative outcome after liver surgery.
  
  
  METHODS
  Between January 2005 and July 2012 460 hepatic resections were performed in patients aged 60 years or younger and 70 years or older at the University Hospital Aachen and University Hospital Maastricht. The postoperative outcome of hepatic resection was evaluated by the time of intensive care unit (ICU) stay, length of hospital stay, appearance of postoperative complications and in-hospital mortality.
  
  
  RESULTS
  The median postoperative hospital stay was 7 days in group ≤60 and 8 days in group ≥70 (p = 0.007). The median time of ICU stay was 1 day in both groups. There were no statistically significant differences according to liver related complications. In group ≥70, significantly more patients suffered from pneumonia (8% vs. 2% in group ≤60, p = 0.015). The overall mortality rate was 3.5%.
  
  
  CONCLUSIONS
  Age alone should not be a contraindication for liver resection. However, elderly patients who develop pneumonia are at high risk for postoperative mortality. Therefore, factors such as short time of invasive ventilation, direct and intensive respiratory therapy and mobilization are of particular importance and should be focused on even more.
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, Uniklinikum RWTH Aachen, Germany. Electronic address: aandert@ukaachen.de.
authors.forename: Anne
authors.initials: A
authors.lastname: Andert
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, The Netherlands.
authors.forename: Toine
authors.initials: T
authors.lastname: Lodewick
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, Uniklinikum RWTH Aachen, Germany.
authors.forename: Tom Florian
authors.initials: TF
authors.lastname: Ulmer
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, Uniklinikum RWTH Aachen, Germany.
authors.forename: Max
authors.initials: M
authors.lastname: Schmeding
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, Uniklinikum RWTH Aachen, Germany.
authors.forename: Wenzel
authors.initials: W
authors.lastname: Schöning
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, Uniklinikum RWTH Aachen, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Neumann
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, The Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: Dejong
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, Uniklinikum RWTH Aachen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Heidenhain
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D055815:Young Adult
keywords: Elderly patients; Liver resection