Outcomes of Ambulatory General Surgery in Older Patients: A Retrospective Study

Introduction: Older adults represent a growing proportion of surgical patients. Ambulatory surgery is increasingly used for its efficiency and lower costs. This study assessed its safety in individuals over 75 compared to younger cohorts. Methods: A retrospective observational study was conducted in a dedicated Ambulatory Surgery Unit, including patients over 75 years of age who underwent general surgical procedures under general anesthesia from January 2020 to January 2023. Ambulatory surgery was defined as procedures requiring less than 24 hours of hospital stay, including cases with overnight observation. A control group of patients under 75 years was selected through simple random sampling. The primary outcome was surgical reintervention within 30 days. Secondary outcomes included emergency department visits and postoperative complications. Data on comorbidities, ASA classification, and postoperative morbidity were collected and analyzed. Statistical comparisons employed chi-square tests, t-tests, or ANOVA as appropriate, with a significance threshold of p < 0.05. Results: A total of 405 patients were included, of whom 205 were aged over 75 and 200 were under 75. Older patients had significantly higher ASA scores (p < 0.001) and Charlson Comorbidity Index values (1.89 ± 1.6 vs. 1.37 ± 1.4; p = 0.001). Despite this, no significant differences were observed in surgical reintervention rates (1.0% vs. 2.0%; p = 0.394) or overall complication rates (17.1% vs. 15.5%; p = 0.668). Most complications in both groups were minor (Clavien-Dindo grade I-II). Unplanned emergency visits were significantly less frequent in the older cohort (1.0% vs. 4.5%; p = 0.029). Hospital stays longer than 24 hours occurred in only 1.0% of elderly patients. No differences were found in procedure type distribution between age groups. Discussion: Our findings suggest that ambulatory general surgery is a safe and feasible option for patients aged over 75 when appropriate selection criteria are applied. Despite higher comorbidity and ASA scores, elderly patients experienced comparable complication and reintervention rates to younger counterparts, with significantly fewer unplanned emergency visits. These results highlight the importance of functional status and overall health rather than age alone in determining surgical eligibility. Conclusion: Ambulatory surgery can be safely offered to selected elderly individuals. Comprehensive preoperative evaluation, rather than chronological age, should guide surgical decisions in this growing population.