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Multifactorial analysis of prognostic factors in major abdominal surgery in patients over 80
I Nudelman1, R Riess, A A Deutsch
1Department of Surgery B, Beilinson Medical Center, Petah Tiqva, Israel.
Objective:
The principle aim of the study was to identify by multifactorial analysis the combination of factors predictive of mortality after major laparotomy in patients over 80 years old.
Design:
A computer held data base established by the authors in 1978 was used to register all relevant information of all major laparotomies performed in patients above 80.
Results:
Unifactorial analysis of mortality disclosed the following factors associated with increased postoperative mortality: 1. Age 85 or more; 2. ASA fitness status 4 or 4; 3. Emergency procedure; 4. Presence of advanced malignant disease; 5. Diagnostic group 5 or 9 (mesenteric occlusion, pancreato biliary malignancy). Multifactorial analysis disclosed low mortality (2.5%) in cases with no gravity factors and very high mortality (above 70%) in those with 3 or more gravity factors.