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[Surgery in advanced age].

H D Clevert1, W Ostach, B Rohleder-Telkamp

  • 1DRK-KH Mark Brandenburg, Chirurgische Abteilung, Berlin.

Zeitschrift Fur Gerontologie
|May 1, 1991
PubMed
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Surgery in very elderly patients (85+) carries a significant risk, with an overall mortality rate of 16.8%. Emergency operations showed higher mortality (28.2%) compared to elective procedures (11.4%).

Area of Science:

  • Geriatric Surgery
  • Surgical Outcomes
  • Patient Risk Assessment

Background:

  • Hospitalization rates for patients aged 85 and older between 1982 and 1990.
  • Prevalence of surgical interventions in this elderly demographic.

Purpose of the Study:

  • To analyze surgical mortality rates in patients aged 85 years and older.
  • To compare mortality between emergency and elective surgeries in this age group.
  • To evaluate the utility of preoperative diagnostic tools in risk assessment.

Main Methods:

  • Retrospective analysis of 724 hospitalized patients aged 85-102 years.
  • Data collection on surgical interventions, mortality, and operation type (emergency vs. elective).
  • Assessment of electrocardiogram (ECG) and chest X-ray findings for risk stratification.

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Main Results:

  • 66.6% of patients underwent surgery, with an overall surgical mortality of 16.8%.
  • Mortality for emergency operations was 28.2%, significantly higher than for elective operations (11.4%).
  • Preoperative chest X-ray and ECG were reliable indicators of surgical risk.

Conclusions:

  • Surgery in patients 85 years and older is associated with substantial mortality.
  • Elective surgery offers a better prognosis than emergency surgery in this population.
  • Diagnostic imaging and ECG are crucial for assessing surgical risk in the very elderly.