Emergency operations in the elderly: management and outcome

For the purpose of highlighting the problems that arise in emergency surgical procedures in elderly patients and of defining safe management, the records of 797 patients aged over 70, operated urgently during a 22-year period, were reviewed. The mortality was 18.4% in the emergency and 4.5% in the elective operations (p < 0.0001). There was no correlation between mortality rates in different age groups. The majority of the patients (67.3%) with coexisting cardio or pulmonary diseases expired. The mortality was significantly lower in the second 11-year period (1982-1992) (14%) than in the first one (1971-1981) (23.8%), (p < 0.0001). In conclusion, age is not a contraindication for an emergency operation and does not affect mortality which appears to be directly related to the severity and nature of the disease and to the coexisting cardio pulmonary diseases. We must advise the elderly to be operated on timely. In some severe surgical conditions it is wise to perform ad hoc the most conservative operation.