Higher Surgery Risks in Elderly Demand Special Attention

Studies document elevated mortality and complication rates among elderly

FRIDAY, Dec. 25 (HealthDay News) -- Common and emergency surgery carries elevated risks of mortality and complications in the elderly, and clinicians should counsel patients on these risks and make every effort to mitigate them, according to a pair of studies in the December issue of the Archives of Surgery.

In one study, Nader N. Massarweh, M.D., of the University of Washington in Seattle, and colleagues analyzed data on 101,318 people 65 years and older who had abdominal surgeries from 1987 to 2004. The 90-day mortality rate in the group was 5.4 percent. and the frequency of complications increased with age to 22.7 percent for patients over 90 years of age. The cumulative incidence of complications within 90 days was 17.3 percent, and the odds of early death also increased with age.

In another study, Edward A. McGillicuddy, M.D., of Yale University in New Haven, Conn., and colleagues analyzed mortality and morbidity data on 292 patients 65 years or older who had emergency colorectal procedures from 2000 to 2006. In-hospital mortality was 15 percent, and the complication rate was 35 percent. In-hospital mortality was associated with age, septic shock, blood loss, delay to operation and complications, while morbidity was associated with operation duration, shock, renal insufficiency, and intra-abdominal contamination/peritonitis.

"Minimizing the delay to definitive operative care may improve outcomes. These procedures frequently involve locally advanced colorectal cancer, emphasizing the need for improved colorectal cancer screening," McGillicuddy and colleagues write.

Abstract - Massarweh
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Abstract - McGillicuddy
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