Related Experiment Video
Updated: May 10, 2026
12:10
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
[Postoperative survival among nonagenarians: a retrospective study]
Dagoberto Ojeda1, Florence Gazabatt, Patricia Cisternas
1Servicio de Anestesiología, Clínica Dávila, Santiago, Chile. eojedadinamarca@gmail.com
Revista Medica De Chile
|June 5, 2013
Summary
Postoperative survival in nonagenarian surgery patients is 50% at two years. Key risk factors for mortality include cardiac disease, cognitive impairment, cancer, and ASA Class III.
Area of Science:
- Geriatric Anesthesiology
- Surgical Outcomes Research
- Epidemiology of Aging
Context:
- The Chilean population is aging, increasing the number of nonagenarians undergoing surgery.
- Anesthesiologists frequently encounter elderly patients, necessitating an understanding of surgical risks in this demographic.
Purpose:
- To determine postoperative survival duration in nonagenarian surgical patients.
- To identify significant risk factors associated with mortality in this age group at a private clinic.
Summary:
- A review of 167 nonagenarian patients (≥90 years) revealed a median survival of two years post-surgery.
- Mortality predictors included cardiac disease, cognitive impairment, cancer, blood transfusion, and American Society of Anesthesiologists (ASA) Class III.
- 50% mortality was observed two years after surgery in this cohort.
Impact:
- This study provides crucial data for risk assessment and perioperative management of nonagenarian surgical patients.
- Identified risk factors can guide clinical decision-making and improve patient outcomes in extreme elderly surgical candidates.
- Highlights the need for specialized anesthetic and surgical care considerations for the very elderly.
Related Concept Videos
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
01:21Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
01:20Actuarial Approach
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...