Short-term autonomy and survival after hepatectomy in the elderly

Area of Science:

• Hepatobiliary Surgery
• Geriatric Medicine
• Oncology

Background:

• Hepatectomy is a complex procedure with potential risks, especially in elderly populations.
• Assessing the impact of hepatectomy on elderly patients' autonomy is crucial for comprehensive care.

Purpose of the Study:

• To evaluate morbi-mortality and survival rates after hepatectomy in elderly patients.
• To determine the influence of hepatectomy on the short-term autonomy of elderly individuals.

Main Methods:

• Retrospective study comparing patients <65 years (controls) to patients ≥65 years (cases) from 2002-2017.
• Geriatric data collected retrospectively; cases stratified into age subgroups (65-70, 70-80, >80 years).

Main Results:

• No significant age-related differences in major hepatectomies, length of stay, 90-day mortality, or surgical complications.
• Elderly patients showed similar overall and disease-free survival but a decreased home discharge rate and increased early loss of autonomy.
• Independent predictors of autonomy loss included age >70, cholangiocarcinoma, prolonged hospital stay, and metachronous colorectal cancer.

Conclusions:

• Elderly patients undergoing hepatectomy experience comparable surgical management and survival to younger patients.
• A significant increase in early loss of autonomy was observed in elderly patients post-hepatectomy.
• Age, specific cancer types, and hospital stay duration are key factors influencing post-hepatectomy autonomy in older adults.