Iain Wilson1, Michael Paul Barrett1, Ashish Sinha1, Shirley Chan2. 1. Department of General Surgery, Medway Maritime Hospital, Windmill Rd, Gillingham, Kent ME7 5NY, UK. 2. Department of General Surgery, Medway Maritime Hospital, Windmill Rd, Gillingham, Kent ME7 5NY, UK. Electronic address: shirley.chan@medway.nhs.uk.
Abstract
INTRODUCTION: Elderly patients are often judged to be fit for emergency surgery based on age alone. This study identified risk factors predictive of in-hospital mortality amongst octogenarians undergoing emergency general surgery. METHODS: A retrospective review of octogenarians undergoing emergency general surgery over 3 years was performed. Parametric survival analysis using Cox multivariate regression model was used to identify risk factors predictive of in-hospital mortality. Hazard ratios (HR) and corresponding 95% confidence interval were calculated. RESULTS: Seventy-three patients with a median age of 84 years were identified. Twenty-eight (38%) patients died post-operatively. Multivariate analysis identified ASA grade (ASA 5 HR 23.4 95% CI 2.38-230, p = 0.007) and chronic obstructive pulmonary disease (COPD) (HR 3.35 95% CI 1.15-9.69, p = 0.026) to be the only significant predictors of in-hospital mortality. CONCLUSIONS: Identification of high risk surgical patients should be based on physiological fitness for surgery rather than chronological age. Crown
INTRODUCTION: Elderly patients are often judged to be fit for emergency surgery based on age alone. This study identified risk factors predictive of in-hospital mortality amongst octogenarians undergoing emergency general surgery. METHODS: A retrospective review of octogenarians undergoing emergency general surgery over 3 years was performed. Parametric survival analysis using Cox multivariate regression model was used to identify risk factors predictive of in-hospital mortality. Hazard ratios (HR) and corresponding 95% confidence interval were calculated. RESULTS: Seventy-three patients with a median age of 84 years were identified. Twenty-eight (38%) patients died post-operatively. Multivariate analysis identified ASA grade (ASA 5 HR 23.4 95% CI 2.38-230, p = 0.007) and chronic obstructive pulmonary disease (COPD) (HR 3.35 95% CI 1.15-9.69, p = 0.026) to be the only significant predictors of in-hospital mortality. CONCLUSIONS: Identification of high risk surgical patients should be based on physiological fitness for surgery rather than chronological age. Crown
Authors: A Vilches-Moraga; J Fox; A Paracha; A Gomez-Quintanilla; J Epstein; L Pearce Journal: Ann R Coll Surg Engl Date: 2018-06-18 Impact factor: 1.891
Authors: Jason W Smith; Jennifer Knight Davis; Catherine C Quatman-Yates; Brittany L Waterman; Scott A Strassels; Jen D Wong; Victor K Heh; Holly E Baselice; Guy N Brock; Brian C Clark; John F P Bridges; Heena P Santry Journal: J Am Geriatr Soc Date: 2019-07-13 Impact factor: 5.562