BACKGROUND: As the aging population continues to increase, the surgical needs of the elderly will increase. The acute care surgery model has been developed in which the trauma team also manages all general surgical emergencies to improve patient outcomes. We retrospectively reviewed our elderly acute care surgery population during the past 5 years to determine the variables affecting major abdominal surgery outcomes. METHODS: Patients aged 80 years and older who received an emergent major abdominal operation by our Acute Care Surgery team between July 2000 and November 2006 were included. We assessed after-hours operations, length of stay, duration of operation, gender, comorbidities, and mortality. Administrative, operating room, and corporate databases were used for demographics, comorbidities, admission logistics, American Society of Anesthesiologists (ASA) score, and mortality. We performed SPSS, chi2, and logistic regression analyses. RESULTS: A total of 183 operations were performed with a mortality of 15%. Significant predictors were ASA score and female gender, with increasing ASA scores leading to worse outcomes and women faring worse than men as an independent variable. Neither operative duration nor off-hours surgery was associated with increased mortality. CONCLUSIONS: This is the first study to report mortality data and expected survival curves for major abdominal surgery in the octogenarian population. Our data prove that it is safer than previously thought to operate on the elderly. Our mortality data and survival curves provide real data for the surgeon to be able to risk stratify and discuss predicted outcomes with consultants, patients, and families.
BACKGROUND: As the aging population continues to increase, the surgical needs of the elderly will increase. The acute care surgery model has been developed in which the trauma team also manages all general surgical emergencies to improve patient outcomes. We retrospectively reviewed our elderly acute care surgery population during the past 5 years to determine the variables affecting major abdominal surgery outcomes. METHODS:Patients aged 80 years and older who received an emergent major abdominal operation by our Acute Care Surgery team between July 2000 and November 2006 were included. We assessed after-hours operations, length of stay, duration of operation, gender, comorbidities, and mortality. Administrative, operating room, and corporate databases were used for demographics, comorbidities, admission logistics, American Society of Anesthesiologists (ASA) score, and mortality. We performed SPSS, chi2, and logistic regression analyses. RESULTS: A total of 183 operations were performed with a mortality of 15%. Significant predictors were ASA score and female gender, with increasing ASA scores leading to worse outcomes and women faring worse than men as an independent variable. Neither operative duration nor off-hours surgery was associated with increased mortality. CONCLUSIONS: This is the first study to report mortality data and expected survival curves for major abdominal surgery in the octogenarian population. Our data prove that it is safer than previously thought to operate on the elderly. Our mortality data and survival curves provide real data for the surgeon to be able to risk stratify and discuss predicted outcomes with consultants, patients, and families.
Authors: Kevin B Ricci; Amy P Rushing; Angela M Ingraham; Vijaya T Daniel; Anghela Z Paredes; Adrian Diaz; Victor K Heh; Holly E Baselice; Wendelyn M Oslock; Scott A Strassels; Heena P Santry Journal: J Trauma Acute Care Surg Date: 2019-10 Impact factor: 3.313
Authors: Wendelyn M Oslock; Anghela Z Paredes; Holly E Baselice; Amy P Rushing; Angela M Ingraham; Courtney Collins; Kevin B Ricci; Vijaya T Daniel; Adrian Diaz; Victor M Heh; Scott A Strassels; Heena P Santry Journal: Am J Surg Date: 2019-07-17 Impact factor: 2.565
Authors: Hassen Hentati; Chady Salloum; Philippe Caillet; Eylon Lahat; Mara Disabato; Eric Levesque; Philippe Compagnon; Chetana Lim; Daniel Azoulay Journal: World J Surg Date: 2018-07 Impact factor: 3.352
Authors: Heena P Santry; John C Madore; Courtney E Collins; M Didem Ayturk; George C Velmahos; L D Britt; Catarina I Kiefe Journal: J Trauma Acute Care Surg Date: 2015-01 Impact factor: 3.313