The outcomes of the elderly in acute care general surgery

St-Louis, Etienne; Sudarshan, Monisha; Alhabboubi, M; Hassan, M. El-Husseini; Deckelbaum, Dan; Razek, Tarek; Feldman, Liane S.; Khwaja, Kosar

doi:10.1007/s00068-015-0517-9

Cited by 57 publications

(31 citation statements)

References 31 publications

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“…It is known that emergency surgery presents a greater risk of postoperative complications and mortality in older adults, who have lower organic reserves and increased fragility, making elective surgery preferable whenever possible . In the multivariate analysis, patients who received emergency operation presented significantly reduced long‐term survival, a fact that is also reflected in other studies .…”

Section: Discussionmentioning

confidence: 70%

Five‐year survival after surgery in nonagenarian patients

Fariña-Castro

Roque‐Castellano

Marchena‐Gómez

et al. 2017

Geriatrics Gerontology Int

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Section: Discussionmentioning

confidence: 70%

Five‐year survival after surgery in nonagenarian patients

Fariña-Castro

Roque‐Castellano

Marchena‐Gómez

et al. 2017

Geriatrics Gerontology Int

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“…Alexander et al described that 50.8% of 592 patients ≥ 75 years old were discharged home with skilled services or to a skilled nursing facility after abdominal and pelvic cancer surgery [ 43 ]. Length of hospital stay after non-elective general surgery is found to be longer for older patients compared to younger adults [ 44 , 45 ]. Simmonds et al studied colorectal surgery in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Meningioma surgery in younger and older adults: patient profile and surgical outcomes

et al. 2017

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BackgroundDue to increasing life expectancy, the number of older patients harboring a meningioma is expected to increase. We determined whether preoperative variables and postoperative clinical outcome differ between younger and older adults.MethodsMedical records of meningioma patients were retrospectively analyzed. Preoperative variables were age, gender, neurological symptoms, Karnofsky Performance Status (KPS), American Society of Anesthesiologists Physical Status (ASA)-classification and tumor characteristics. Clinical outcome was assessed using complication rates, length of hospital stay and destination after discharge. After 6–12 and 12–18-month KPS, neurological symptoms and Glasgow Outcome Scale (GOS) scores were assessed for older (age ≥ 65 years) and younger adults (18–65 years) using Mann–Whitney U, T test, Pearson’s Chi square or Fisher’s exact.Results89 patients were included (23 ≥ 65 years). Before surgery, older patients scored higher on ASA classification (p = 0.003) and lower on KPS (p = 0.017). There was no significant difference postoperatively in mortality, complications and duration of hospital stay. Less older patients were discharged directly to home compared to younger adults (52 vs 80%, respectively; p = 0.004). In surviving patients, less older subjects had a good recovery (GOS 4–5) at 6–12 months’ follow-up compared to younger subjects (64 vs 93%, respectively; p = 0.035). At 12–18 months, there was no significant difference in good recovery between both age groups (82 vs 92%).ConclusionIn this cohort, outcome was worse for patients ≥ 65 years old in terms of discharge destination and good recovery at 6–12 months. At 12–18 months follow-up, older subjects performed not significantly different from younger ones. Careful patient selection seems essential to reach good results in meningioma surgery for patients ≥ 65 years old.

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“…Although only 11% of hospital admissions account for emergency procedures, they are responsible for 50% of all in-hospital morbidity and mortality [3][4]. Older patients requiring emergency surgery are most sensitive to disruptions in their physiological and cognitive baselines, such as acute fluid and electrolyte disturbances associated with sepsis or third-space fluid losses.…”

Section: Introductionmentioning

confidence: 99%