Common Perioperative Complications in Older Patients

Lagoo‐Deenadayalan, Sandhya; Newell, Mark A.; Pofahl, Walter E.

doi:10.1007/978-1-4419-6999-6_29

Cited by 12 publications

(10 citation statements)

References 119 publications

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“…Also, high ASA score in elderly patients undergoing abdominal surgery is associated with the higher mortality rate consistent with the present study (6). Increase in the rate of comorbidities with age and decrease in the ability of coping with increased stress due to limited physiological reserves can be suggested as possible causes (14). It was observed that there was no significant change in complication rates with increasing patient age.…”

Section: Discussionsupporting

confidence: 88%

Effects of Lower Gastrointestinal Tract Surgery on Survival in Elderly and Octogenarian Patients

Aydin¹,

Avci²,

Tezcaner³

et al. 2018

tjgeri

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Introduction: Life expectancy has significantly increased in the last decade. The decision to perform surgery has always been challenging in elderly patients. We aimed to evaluate outcomes in patients who underwent surgery for lower gastrointestinal tract diseases and investigate factors influencing morbidity and mortality, particularly in octogenarian patients, and the effects of age on prognosis and survival in the postoperative period. Materials and Method: This study included patients aged ≥70 years who underwent lower gastrointestinal tract surgery; patients were divided into three groups as 70-75 years, 75-79 years, and ≥80 years. Age, gender, type of surgery, ASA score, length of hospital stay, morbidity, 30-day mortality, and overall survival were evaluated. Results: The surgery was performed to 598 patients due to lower gastrointestinal tract diseases. There was a significant increase in the ASA score with increasing age (Chi-square=35.472; p<0.001). The survival rate was significantly higher in patients with malignancies than in those with benign diseases, and in patients who underwent elective surgery than in those who underwent emergency surgery (p<0.001). When patients were examined according to age groups, the overall survival was similar across groups (p=0.217). Conclusion: There was no significant difference between octogenarian and younger patients for complications and survival. Thus, planned surgical interventions in elderly patients will not negatively affect survival and surgical interventions and can be safely performed in these patients.

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Section: Discussionsupporting

confidence: 88%

Effects of Lower Gastrointestinal Tract Surgery on Survival in Elderly and Octogenarian Patients

Aydin¹,

Avci²,

Tezcaner³

et al. 2018

tjgeri

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“…For example, confusion may be the first manifestation of infection, rather than leukocytosis. In addition, myocardial ischemia is estimated to be silent in 80% of elderly patients [5]. Furthermore, management of complications is more complex.…”

Section: Key Pointsmentioning

confidence: 99%

“…Delirium is relatively common after moderate to high-risk surgery, occurring in nearly 50% of patients presenting for open heart surgery and 20-40% of patients presenting for orthopedic, vascular, and colorectal surgery [5]. Furthermore, the development of postoperative delirium is itself a risk factor for subsequent complications [6], prolonged hospital stay [6,7], poorer functional recovery [8,9], and increased short-term mortality [7,8].…”

Section: Introductionmentioning

confidence: 99%

Trends in healthcare and the role of the anesthesiologist in the perioperative surgical home – the US perspective

Holt

2014

Current Opinion in Anaesthesiology

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“…On the basis of the 2006 National Hospital Discharge Survey, patients aged 65 and older accounted for 35 % of all procedures [ 4 ]. A nationwide prevalence study showed that the age distribution of inguinal hernia repair is bimodal peaking at early childhood and old age (75–80 years) [ 5 ].…”

mentioning

confidence: 99%

“…Cardiac events occur in 1–5 % of patients undergoing non-cardiac surgery and pulmonary complications in 2.1–10.2 % of elderly patients [ 4 ].…”

mentioning

confidence: 99%

Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry

et al. 2015

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Introduction Several analyses of hernia registries have demonstrated that patients older than 65 years have significantly higher perioperative complication rates compared with patients up to the age of 65. To date, no special analyses of endoscopic/laparoscopic inguinal hernia surgery or of the relevant additional influence factors have been carried out. Besides, there is no definition to determine whether 65 years should really be considered to be the age limit.MethodsIn the Herniamed Hernia Registry, it was possible to identify 24,571 patients with a primary inguinal hernia and aged at least 16 years who had been operated on between September 1, 2009, and April 15, 2013, using either the TAPP technique (n = 17,214) or TEP technique (n = 7,357). Patients in the age group up to and including 65 years (≤65 years) were compared with those older than 65 years (>65 years) in terms of their perioperative outcome. That was done first using unadjusted analysis and then multivariable analysis.ResultsUnadjusted analysis revealed significantly different results for the intraoperative (1.19 vs 1.60 %; p = 0,010), postoperative surgical (2.72 vs 4.59 %; p < 0.001) and postoperative general complications (0.85 vs 1.98 %; p < 0.001) as well as for complication-related reoperations (1.07 vs 1.37 %; p = 0,044), which were more favorable in the ≤65 years age group. However, in multivariable analysis, it was not possible to confirm that for the intraoperative complications or the reoperations. Reoperations were needed more often for bilateral procedures (p < 0.001; OR 2.154 [1.699; 2.730]), higher ASA classification (IV vs I: p = 0.004; OR 6.001 [1.786; 20.167]), larger hernia defect and scrotal hernias. The impact of these factors, in addition to that of age >65 years, was also reflected in the postoperative complication rates. The age limit for increased onset of perioperative complication rates tends to be more than 80 rather than 65 years.ConclusionThe higher perioperative complication rate associated with endoscopic/laparoscopic inguinal hernia surgery in patients older than 65 years is of multifactorial genesis and is observed in particular as from the age of 80 years.

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Common Perioperative Complications in Older Patients

Cited by 12 publications

References 119 publications

Effects of Lower Gastrointestinal Tract Surgery on Survival in Elderly and Octogenarian Patients

Effects of Lower Gastrointestinal Tract Surgery on Survival in Elderly and Octogenarian Patients

Trends in healthcare and the role of the anesthesiologist in the perioperative surgical home – the US perspective

Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry

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