Effect of Age Alone on Outcome of Acute Surgical Conditions Among Healthy Patients (Non-smokers, Non-obese, and No Comorbid Conditions)

Abstract

Background The impact of age alone in relation to postoperative outcomes needs to be further elucidated. This study investigated whether increasing age was associated with increased morbidity and mortality for patients with no comorbidities undergoing acute care surgery (ACS). Methods The 2016-2018 National Surgical Quality Improvement Project database was used to identify adult patients who underwent ACS performed on an urgent/emergent basis. Patients overweight or with pre-existing medical comorbidities were excluded. Patients were divided into age groups in decades. The association between outcomes and the different age groups, other patient characteristics, and perioperative factors was examined by multivariate logistic regression. Results 22,770 patients were identified, of which 73.5% were appendectomies, and 21.6% were open procedures. Increasing age correlated with higher unadjusted complication rates and mortality. Multivariate analyses revealed that compared to patients ≤ 30 years old, mortality was not different for patients 31-60 years old, but it was higher for the age groups > 61 years old. Patients aged 51-60 and from 71 and above were associated with higher risks of complications. Subset analysis on octogenarians revealed a 1.14-fold higher odds of mortality for every year of increasing age. Preoperative risk factors including open procedure, wound class, and American Society of Anesthesiology (ASA) class were also associated with greater risks of mortality in octogenarians. Conclusion Patients older than age 50 were at higher risk for postoperative complications, and mortality significantly increased for each decade past 60 years old in healthy individuals.

Emergency General Surgery Procedures in Older Adults: Where You Live Matters!

“…Shah et al 23 utilized the Nationwide Inpatient Sample administrative database and assessed the predictors of postoperative complications and mortality in a large national population of EGS patients and identified age as an independent predictor of mortality for all EGS diagnoses. Subsequently, Sebekos et al 24 showed that mortality increased by 1.14-fold for every decade after the age of 60 in older adults undergoing EGSPs. Castillo-Angele et al analyzed Medicare inpatient claims of 882 929 patients and showed that frailty and an increased CCI were associated with an increased risk of mortality, while larger hospital volume, specifically 200 beds or greater, was associated with a decreased risk of in-hospital mortality.…”