A prospective study of elderly general surgical patients: I. Pre-operative medical problems.

A prospective study has been carried out on 288 general surgical patients aged 65 years and over. The present report looks at pre-operative patient characteristics. A high rate of pre-operative morbidity was found, with only one patient in five having no pre-operative medical problem. Evidence of respiratory disease was found in 29%, 14% gave a history of previous congestive heart failure, 9% had symptoms of angina, 5% had had strokes in the past, and 9% had an impaired mental score. In 30% of patients, three or more pre-operative medical problems were detected. When compared with those aged 65-74 years, patients aged 75 years and over were more likely to be admitted non-electively, had significantly more cardiovascular signs and poorer mental scores. When compared with elective admissions, patients admitted non-electively were older, had more clinical and radiological signs of respiratory disease and lower mental scores. The findings of the present study have been compared with previous reports of elderly surgical patients.