Surgical care of patients over eighty: a predictable crisis at hand

The number of people over the age of 80 in Britain will increase by around 30 per cent over the next 15 years. Little attention has been paid to the acute surgical services required to meet the surgical needs of this population. This study reviews 198 surgical admissions in 1 year of patients aged 80 years and over, of which 74.9 per cent were admitted as emergencies. The overall mortality was 10.1 per cent of all admissions and 41 per cent of admissions were accompanied by at least one serious complication. Eighty-eight patients underwent surgery with an operative mortality of 11.3 per cent. In only 63.5 per cent of cases could the patient be discharged directly home. By 2001, in Oxford, the proportion of acute surgical beds occupied by patients aged over 80 will increase to 9.2 per cent from the present 7.0 per cent. Unless additional resources are provided to meet this extra demand for acute surgical care of the old, elective surgery for younger patients will inevitably be curtailed.