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Emergency abdominal surgery in the elderly

J Kettunen1, H Paajanen, S Kostiainen

  • 1Department of Surgery, Kuopio University Hospital, Finland.

Hepato-Gastroenterology
|April 1, 1995
PubMed
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Emergency abdominal surgery outcomes for patients over 65 have improved, especially for those under 80 without comorbidities. However, very elderly patients (over 80) in poor health (ASA classes IV-V) still face high mortality risks.

Area of Science:

  • Surgery
  • Geriatrics
  • Gastroenterology

Background:

  • Emergency abdominal surgery in elderly patients presents significant challenges.
  • The period 1986-1989 saw 201 patients over 65 operated on for acute abdomen.

Purpose of the Study:

  • To evaluate the outcomes of emergency abdominal surgery in patients aged over 65.
  • To identify factors influencing morbidity and mortality in this demographic.

Main Methods:

  • Retrospective review of 201 consecutive patients aged over 65 undergoing emergency abdominal surgery.
  • Analysis of procedure types, postoperative complications, mortality, intensive care needs, re-operations, and hospital stay.

Main Results:

  • Common procedures included biliary tract (24%), appendix (20%), and bowel (15%).

Related Experiment Videos

  • Postoperative morbidity was 26%, with a 22% mortality rate, primarily due to mesenteric thrombosis and obstruction.
  • Patients over 80 and those in ASA classes IV-V had significantly poorer outcomes.

    • Conclusions:

    • Emergency abdominal surgery outcomes have improved for patients under 80 without severe comorbidities.
    • Very elderly patients (over 80) and those with high American Society of Anesthesiologists (ASA) scores (IV-V) continue to experience poor outcomes.