Comparative Mortality for Various Surgical Operations in Older versus Younger Age Groups*

Ziffren, Sidney E.; Hartford, Charles E.

doi:10.1111/j.1532-5415.1972.tb02145.x

Cited by 48 publications

(28 citation statements)

References 11 publications

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“…12 This risk is more significant after age 70, and patients aged 80 years or older are more prone to operative mortality and morbidity. 18 Therefore, we investigated the efficacy of microvascular free tissue transfer in patients aged 70 years or older, in whom the risks of surgery are significantly higher.…”

Section: Discussionmentioning

confidence: 99%

The Safety of Microvascular Free Tissue Transfer in the Elderly Population

Coşkunfırat

Chen

Spanio

et al. 2005

Plastic and Reconstructive Surgery

150

105

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The objective of this study was to evaluate the safety and thus the efficacy of microvascular free tissue transfer in the elderly patient population. Free flaps for different types of reconstructions were analyzed to verify whether free tissue transfer is feasible in the elderly. Between 1993 and 2003, 102 free flaps were performed in 94 patients who were aged 70 years or older. There were 75 male and 19 female patients, with a mean age of 73.8 years (range, 70 to 87 years). Different types of free flaps were performed for head and neck (n = 78), lower extremity (n = 12), and trunk and upper extremity (n = 4) reconstruction. Nine flaps underwent reexploration and four of them were lost, for an overall success rate of 96 percent. Medical complications in the postoperative period were further evaluated. A total of 32 medical complications were seen in 29 patients. Only one patient died because of postoperative complications. The frequency of medical complications was further analyzed in detail. Effects of American Society of Anesthesiologists status, operation time, and age on complication rate were evaluated statistically. Only American Society of Anesthesiologists status was statistically significant for the occurrence of postoperative medical complications; class III and IV patients were at higher risk than class I and II. Neither operation time nor age was predictive of postoperative complications. Microvascular free tissue transfer is a safe and reliable option in the elderly population. The success rate of free flaps is not different from that for other age groups. The rate of postoperative medical complications was 31 percent (29 of 94 patients); most complications were in American Society of Anesthesiologists class III and IV patients.

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Section: Discussionmentioning

confidence: 99%

The Safety of Microvascular Free Tissue Transfer in the Elderly Population

Coşkunfırat

Chen

Spanio

et al. 2005

Plastic and Reconstructive Surgery

150

105

View full text Add to dashboard Cite

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“…18,33,34 In a study by Yano et al, 7 an age of over 70 years was an independent risk factor for major complications after lung resection (respiratory failure, pneumonia, and empyema in over 50% of cases). Duque et al, 4 however, did not find any statistically significant differences when they compared patients aged 70 or over with others aged under 70, but age is probably a risk factor as a result of the associated high frequency of comorbidity.…”

Section: Patient Agementioning

confidence: 98%

“…There are numerous descriptions of risk factors for pneumonia that are present in the perioperative period and that act by altering in some way this balance between the host's defense system and the causal microorganism. These risk factors include alterations in the nutritional state, 17 old age, 18,19 abnormal lung function, 20 the thoracotomy and the lung resection themselves, 4,21 the type and side of the lung resection, 8,22 alteration of the cleaning mechanisms of the bronchial tree, 23 reintubation, 24 smoking, 13,25 and a prolonged preoperative hospital stay, which has been linked to an increase in oropharyngeal colonization, particularly by Gram-negative bacilli. 25,26 …”

Section: Risk Factorsmentioning

confidence: 98%

Respiratory Infections After Lung Cancer Resection

Belda

Cavalcanti

Iglesias

et al. 2006

Clinical Pulmonary Medicine

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The progress that has been made in patient selection, minimally invasive surgery, anesthesia (both in surgery and in the control of postoperative pain), and antibiotic treatments have substantially improved the morbility and mortality associated with the surgical treatment of bronchogenic carcinoma in recent years. Nevertheless, the rate of major complications after lung cancer resection is 2% to 22%, and the mortality rate is 2% to 7%. The most frequent complications after lung cancer resection are of respiratory origin. The most serious ones are pneumonia and acute respiratory distress syndrome, and they are also the main causes of death in this period. They also share similar clinical and evolutionary features that can make it difficult to distinguish between them. The incidence of pneumonia after a lung cancer resection is 2% to 20%, and the mortality in patients that develop pneumonia is significantly higher than in other patients. It is also the cause of death in 22% to 67% of cases after lung resection. Therefore, patients with lung cancer treated with lung resection comprise a population with a high risk of experiencing pneumonia with a serious prognosis. Apart from being one of the main factors that determine short-term survival, postoperative pneumonia prolongs the hospital stay and involves a significant consumption of resources (antibiotics, stay in intensive care unit). For all these reasons, there is growing interest in identifying the factors associated with the risk, prevention, diagnosis, and treatment of respiratory infections after lung cancer resection.Key Words: lung cancer resection, postoperative pneumonia, risk factors (Clin Pulm Med 2006;13: 8 -16) B ronchogenic carcinoma is the most frequent neoplasia (900,000 new cases in men and 330,000 in women per year) and the first cause of death from cancer in the world in both men and women. 1 The overall probability of being alive 5 years after the diagnosis is 15%, a percentage that has barely changed in the last 35 years. 2 This is the result of, among other reasons, diagnosis in the advanced stages of the disease (less than 30% of cases are diagnosed in stages I and II, when the disease is limited and surgical resection offers a probability of survival at 5 years of 70% and 40%, respectively). Early diagnosis is therefore decisive to take advantage of surgical treatment, which is the option that currently offers the greatest probability of a cure to the greatest number of patients (Table 1).The advances made in anesthesia and minimally invasive surgery have allowed surgical indications to be extended to those patients who are at greater risk of experiencing complications or dying after a lung resection. Moreover, multidisciplinary treatments of bronchogenic carcinoma have led to more pneumonectomies, with a subsequent increase in the morbidity and mortality associated with resection. Reducing the complications and mortality associated with the surgical treatment of bronchogenic carcinoma is another important aspect if the potential benefit...

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“…There are numerous descriptions of risk factors for pneumonia that can coincide in the perioperative period and that would act by altering this balance between the host's defense system and the causal microorganism in some way. These risk factors include alteration of the nutritional state [17]; old age [18,19]; deteriorated lung function [20]; thoracotomy and lung resection themselves [4,21]; type and side of the lung resection [8,22]; alteration to the cleaning mechanisms of the bronchial tree [23]; reintubation [24]; smoking [13,25]; and a prolonged preoperative hospital stay, which has been linked to an increase in oropharyngeal colonization, particularly by Gram-negative bacilli [25,26].…”

Section: Risk Factorsmentioning

confidence: 99%