Advanced age does not contribute to increased risks or poor outcome after major abdominal operations

Area of Science:

• Surgical Oncology
• Geriatric Surgery
• Gastrointestinal Surgery

Background:

• Elderly patients are often excluded from major surgeries due to concerns about increased morbidity and mortality.
• The impact of advanced age on outcomes after major gastrointestinal resections requires further investigation.

Purpose of the Study:

• To evaluate the effect of advanced age on morbidity, mortality, and long-term outcomes in patients undergoing major gastric and pancreatic resections.
• To determine if age criteria alone should prevent elderly patients from undergoing these procedures.

Main Methods:

• Retrospective review of 179 patients who underwent major gastrectomy or pancreatectomy between July 1987 and June 2000.
• Analysis using Chi-square and regression, comparing outcomes between elderly (>=70 and >=80 years) and younger patient groups.
• Assessment of in-hospital deaths, 90-day mortality, complication rates, intensive care unit (ICU) and hospital stay, and survival rates.

Main Results:

• No in-hospital or 90-day deaths occurred in patients over 70 years old.
• Overall and major complication rates were not significantly higher in older patients.
• Survival and disease-free survival rates were comparable or superior in elderly patients, particularly for gastric cancer.

Conclusions:

• Advanced age (>=70 years) does not independently increase hazards for patients undergoing major gastric or pancreatic resections.
• Disease and procedure-related factors, not age, are significant predictors of complications and longer hospital stays.
• Elderly patients should not be denied major gastric or pancreatic surgery based on age alone.