Criteria to consider when assessing the mortality risk in geriatric surgery

As the population ages, surgery is performed more frequently on geriatric patients for both elective and emergency situations. Four hundred sixty-nine patients > or = 70 years of age who underwent operations were retrospectively reviewed. Sex, American Society of Anesthesiologists (ASA) score, type of admission, main surgical diagnosis, benign or malignant nature, site of disease, concomitant disease, preoperative ASA grade, and death were assessed. The ratio of the elderly against all those who were operated on in our department during the same period was 5.9%. The mortality rate was 8.5% for men and 9.4% for women. According to ASA scoring, mortality rates were 0%, 8.8%, 29.8%, 36.8%, and 66.6%, respectively (P < 0.05). The mortality rate was 2.5% for elective and 49.2% for emergency procedures (P < 0.0001). The mortality rate was 9.7% for benign and 7.2% for malignancy. Hepatopancreatic biliary conditions were most common (39.6%), followed by colorectal (19.4%), hernia (18.8%), upper gastrointestinal (15.3%), and endocrine disease (6.9%). The highest mortality rate was for diseases of the upper gastrointestinal system (30.5%; P < 0.001). The incidence of associated disease was 13.1% in patients who died (P < 0.005). Overall mortality rate in this study was 8.9%. In emergency surgery, the presence of associated disease, an ASA score of III-V, and upper gastrointestinal surgery affected the risk of postoperative death in elderly patients.