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Related Experiment Videos

Risk-adjusted general surgical audit in octogenarians.

Kirstin G Nichols1, David R Prytherch, Micheal F Fancourt

  • 1Department of General Surgery, Taranaki Base Hospital, New Plymouth, Taranaki, New Zealand. kirstin_grace@hotmail.com

ANZ Journal of Surgery
|October 31, 2008
PubMed
Summary

Outcomes for surgical patients over 80 years old were acceptable, with a risk-adjusted scoring tool accurately predicting mortality. Further validation is needed for elective surgical cases.

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Area of Science:

  • Geriatric Surgery
  • Surgical Outcomes Research
  • Patient Risk Stratification

Background:

  • Increasing surgical admissions in patients over 80 years old present unique challenges.
  • Age-related comorbidities heighten the risk of complications and mortality in this demographic.
  • Evaluating current outcomes and risk prediction tools is crucial for this growing patient population.

Purpose of the Study:

  • To document current morbidity and mortality outcomes for patients over 80 admitted to a general surgical unit.
  • To assess the accuracy of a risk-adjusted scoring tool in predicting outcomes for both operative and non-operative elderly surgical patients.

Main Methods:

  • Prospective audit of all patients over 80 years old admitted to the general surgical unit over an 11-month period.

Related Experiment Videos

  • Collection of morbidity and mortality data using standardized pro forma.
  • Comparison of observed outcomes with predictions from a risk-adjusted scoring tool.

    • Main Results:

    • 243 admissions in 223 patients (8.2% readmission rate) included emergency (28.8%), elective (33.8%), and non-operative (37.5%) cases.
    • Complication rates were highest in emergency admissions (47.1%).
    • Thirty-day mortality rates varied: 15.7% for emergency, 0% for elective, and 17.4% for non-operative admissions. Emergency laparotomy had a 31.6% mortality.
    • The risk-adjusted scoring tool showed no significant lack of fit between observed and predicted deaths across all groups.

    Conclusions:

    • Morbidity and mortality outcomes for elderly surgical patients at Taranaki Base Hospital were comparable to published data.
    • The risk-adjusted prediction tool demonstrated favorable comparison with observed outcomes.
    • Further data collection is recommended to validate the tool's accuracy specifically for elective surgical patients.