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Thoracic surgery in the elderly--co-morbidity is the limit
Stefan Limmer1, Lena Hauenschild, Christian Eckmann
1Department of Surgery, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Stefan.limmer@uk-sh.de
Interactive Cardiovascular and Thoracic Surgery
|January 13, 2009
Summary
Elderly patients can undergo thoracic surgery with acceptable outcomes. Emergency surgery and high co-morbidity are key risk factors for mortality and prolonged hospital stays in older adults.
Area of Science:
- Geriatric Surgery
- Thoracic Surgery
- Perioperative Outcomes
Background:
- The elderly population is growing, necessitating evaluation of surgical risks in this demographic.
- Thoracic surgery in patients aged 65 years and older requires careful risk assessment.
Purpose of the Study:
- To evaluate perioperative mortality and morbidity in elderly patients undergoing thoracic surgery.
- To identify risk factors associated with adverse outcomes in this patient group.
Main Methods:
- Retrospective chart review of 242 consecutive patients aged 65+ undergoing 249 thoracic procedures.
- Analysis of patient demographics, comorbidities, surgical urgency, and perioperative outcomes.
Main Results:
- Overall operative mortality was 2.4%, significantly higher (26.4%) in emergency cases.
- Negative predictors for mortality included American Society of Anesthesiology (ASA) class 4, kidney failure, leucocytosis, low hemoglobin, elevated C-reactive protein, diabetes, and emergency surgery.
- Increased risk of complications and prolonged hospital stay was linked to emergency surgery, multiple comorbidities, and ASA class 3 or 4.
Conclusions:
- Thoracic surgery is feasible in the elderly with acceptable risk.
- High comorbidity and emergency status are the primary determinants of adverse perioperative events, irrespective of age.
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