Older age impacts outcomes after adrenalectomy

Area of Science:

• Surgical outcomes research
• Geriatric surgery
• Adrenal gland surgery

Background:

• Adrenalectomy is a well-tolerated procedure with low complication rates.
• Existing data suggest excellent outcomes, but consistency across different age groups remains unclear.

Purpose of the Study:

• To evaluate the impact of age on adrenalectomy outcomes.
• To compare patient characteristics, surgical indications, and postoperative results across various age demographics.

Main Methods:

• Utilized the 2015-2020 American College of Surgeons National Surgical Quality Improvement Program datasets.
• Categorized 6,114 adrenalectomy patients into age groups: ≤60, 61-70, 71-80, and >80 years.
• Compared outcomes including mortality, morbidity, length of stay, discharge destination, and readmission using multivariable logistic regression.

Main Results:

• While overall mortality was low (<1%) and consistent across age groups, morbidity and non-home discharge rates significantly increased with age.
• Patients >80 years had double the likelihood of morbidity and a nine-fold increased likelihood of non-home discharge compared to those ≤60.
• Younger patients were more likely to undergo surgery for non-functional benign neoplasms, whereas older patients had higher rates of malignancy.

Conclusions:

• Older age is a significant risk factor for increased morbidity and non-home discharge following adrenalectomy.
• These findings are crucial for informed consent and surgical planning in elderly patients undergoing adrenalectomy.