A review of morbidity and mortality in elderly patients undergoing pulmonary resection

The morbidity and 30-day operative mortality were reviewed in the 43 patients 70 years of age or older who underwent pulmonary resection between June 1976 and May 1981. In addition to their surgical illness, many of these patients had pre-existing medical conditions including: coronary artery disease (8), hypertension (14), diabetes (4), and congestive heart failure (5). The mean preoperative 1 second forced expiratory volume (FEV1) was 1.7 liters and 17 patients had an FEV1 of less than 1.5 liters. The operative mortality was 2.3% (one patient), the average duration of postoperative hospital confinement was 9 days, and 39 of 42 (93%) of the patients were discharged within 2 weeks of their operation. There were 38 postoperative complications in 25 of the 42 survivors, most of which were minor and all of which were resolved. Problems included: air leak (13), atrial fibrillation or flutter (3), myocardial infarction (1), respiratory difficulties (9), hemorrhage (2), mental confusion (3), hyperpyrexia (3), difficult-to-manage diabetes (1), and social problems (3). Only two patients required prolonged mechanical ventilation. The low operative mortality, the short postoperative stay, and the minimal number of serious complications is contrasted with other published reports describing a high-operative mortality in elderly patients. The improvement may be related to recent advances in postoperative management and anesthetic techniques. These data suggest that advanced age is not a contraindication to curative pulmonary resection.