SUMMARYThe results of 375 emergency abdominal operations in elderly patients over the age of 75 years are presented and discussed in detail. There has been a fourfold increase in the population over the age of 75 years in England and Wales during the 60-year period from 1911 to 1971. The overall mortality of these patients of 31.7per cent is unrelated to the age of the patient, but appears to be directly related to the severity of the surgical condition and to cardiorespiratory complications. Our approach to these problems is presented and discussed.THE widespread application of preventive medicine and improved medical resources in the twentieth century has resulted in an increase in the number of elderly people in our community. In certain areas this is accentuated by an influx of retired people. Bournemouth is such a 'retirement' area as demonstrated by the 1971 census which showed a total population of 183332 with 19339 people over the age of 75 years (Office of Population Censuses and Surveys, 1973). This represents 10.5 per cent of the local population. In comparison with the national figures this is twice the average (Office of Population Censuses and Surveys, 1975). Because of the large numbers of elderly people in our local community we decided to study the results of emergency abdominal surgery in patients over the age of 75 years. PatientsWe have defined a case as an emergency if it was deemed deleterious to the patient to delay surgery until the next routine operating list. The age limit of 75 years was taken arbitrarily, as we considered anyone over the age of 75 years represented a geriatric patient. The cases were collected from the theatre operation registers and included both public and private patients who were admitted to the Royal Victoria Hospital, Bournemouth. During the 6)-year period from January 1969 to March 1975,392emergency abdominal operations were performed on patients over the age of 75 years. Of these, the case records were obtained for 375 operations, representing a retrieval rate of 95.7 per cent. Using a prepared pro forma, a retrospective examination of the notes was undertaken with regard to the patients' age, sex, general clinical condition, details of operation, complications and mortality. A period of 30 days following operation was taken as an arbitrary figure in which morbidity and mortality resulting from surgery were considered likely to occur.

No abstract

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