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Surgical care in octogenarians

A Bufalari1, M Ferri, P Cao

  • 1Department of Surgery and Surgical Emergencies, University of Perugia, Italy.

The British Journal of Surgery
|December 1, 1996
PubMed
Summary
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Octogenarian surgery patients face higher mortality and morbidity risks. Key predictors for adverse outcomes include American Society of Anesthesiologists score, multiple comorbidities, and laparotomy procedures.

Area of Science:

  • Geriatric Surgery
  • Surgical Outcomes Research
  • Patient Safety

Background:

  • Octogenarian (80+ years) admissions and surgical rates increased significantly between 1989-1993.
  • Emergency admissions and operations were more prevalent in octogenarians compared to younger cohorts.
  • The study aimed to analyze the surgical profile and identify risk factors for mortality and morbidity in octogenarian patients.

Purpose of the Study:

  • To compare the surgical characteristics of octogenarians with younger patients.
  • To identify independent risk factors for operative mortality and morbidity in octogenarian surgical patients.

Main Methods:

  • Retrospective analysis of a surgical database from 1989-1993.
  • Inclusion of 934 octogenarian admissions, with 447 undergoing surgery.

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  • Multiple logistic regression analysis to determine independent risk factors.

    • Main Results:

    • Octogenarian mortality rate was significantly higher than in younger patients (P < 0.01).
    • Overall postoperative mortality and morbidity rates were 10.1% and 32.2%, respectively.
    • Independent risk factors for mortality/morbidity included American Society of Anesthesiologists (ASA) score II-V (P < 0.01), two or more comorbidities (P < 0.01), and laparotomy (P < 0.03).

    Conclusions:

    • Octogenarian patients represent a growing surgical population with elevated risks.
    • Preoperative assessment, including ASA score and comorbidity evaluation, is crucial for risk stratification.
    • Laparotomy procedures are associated with increased postoperative mortality and morbidity in this age group.