Mortality after abdominal emergency surgery in nonagenarians

Area of Science:

• Geriatric Surgery
• Surgical Outcomes Research
• Emergency Abdominal Surgery

Background:

• Nonagenarians represent a rapidly growing demographic undergoing complex surgical procedures.
• Emergency abdominal surgery in this age group is associated with significant morbidity and mortality.
• Predictive tools are crucial for optimizing care and resource allocation.

Purpose of the Study:

• To investigate the diagnostic patterns in nonagenarians undergoing emergency abdominal surgery.
• To evaluate pre-hospital functional status as a predictor of postoperative mortality in this population.

Main Methods:

• Observational study of 157 nonagenarian patients undergoing emergency abdominal surgery.
• Retrospective data extraction from electronic patient files and operation databases.
• Analysis of short, middle, and long-term mortality, with identification of preoperative predictors.

Main Results:

• Intestinal obstruction was the most common indication for surgery.
• Overall 30-day mortality was 34%, and 1-year mortality was 54%.
• High American Society of Anesthesiologists (ASA) class and poor Performance Status (PS) were significant predictors of mortality.

Conclusions:

• Pre-admission functional status is a valuable criterion for predicting postoperative mortality in nonagenarians.
• These findings support the use of functional assessment in surgical decision-making for very elderly patients.