TY - JOUR
T1 - Major abdominal surgery in octogenarians
T2 - should high age affect surgical decision-making?
AU - Straatman, Jennifer
AU - Van der Wielen, Nicole
AU - Cuesta, Miguel A
AU - de Lange-de Klerk, Elly S M
AU - van der Peet, Donald L
N1 - Copyright © 2016 Elsevier Inc. All rights reserved.
PY - 2016/11
Y1 - 2016/11
N2 - BACKGROUND: Over the last decades longevity has increased significantly, with more octogenarians undergoing surgery. Here, we assess surgical outcomes after major abdominal surgery in octogenarians.METHODS: Observational cohort of 874 patients undergoing major abdominal elective surgery between January 2009 and March 2014. Seventy-six octogenarians were propensity matched to 76 younger patients, corrected for sex, body mass index, American Society of Anesthesiologists classification, comorbidity, indication, and type of surgery.RESULTS: Minor complications were more prevalent in octogenarians (P = .01) and consisted mainly of respiratory complications; progressing to respiratory insufficiency requiring intubation in 28.6%. Preoperative weight loss (odds ratio 3 [1.1 to 8.3]) and upper gastrointestinal surgery (odds ratio 11 [2 to 60]) were associated with minor complications.CONCLUSIONS: Octogenarians are at increased risk of minor complications after major abdominal surgery. Major complication rates were similar, indicating the importance of preoperative assessment and standardized surgical techniques. Taking into account preoperative morbidities and type of surgery and techniques. Implementation of quality control algorithms may further improve outcomes in octogenarians.
AB - BACKGROUND: Over the last decades longevity has increased significantly, with more octogenarians undergoing surgery. Here, we assess surgical outcomes after major abdominal surgery in octogenarians.METHODS: Observational cohort of 874 patients undergoing major abdominal elective surgery between January 2009 and March 2014. Seventy-six octogenarians were propensity matched to 76 younger patients, corrected for sex, body mass index, American Society of Anesthesiologists classification, comorbidity, indication, and type of surgery.RESULTS: Minor complications were more prevalent in octogenarians (P = .01) and consisted mainly of respiratory complications; progressing to respiratory insufficiency requiring intubation in 28.6%. Preoperative weight loss (odds ratio 3 [1.1 to 8.3]) and upper gastrointestinal surgery (odds ratio 11 [2 to 60]) were associated with minor complications.CONCLUSIONS: Octogenarians are at increased risk of minor complications after major abdominal surgery. Major complication rates were similar, indicating the importance of preoperative assessment and standardized surgical techniques. Taking into account preoperative morbidities and type of surgery and techniques. Implementation of quality control algorithms may further improve outcomes in octogenarians.
KW - Journal Article
U2 - 10.1016/j.amjsurg.2016.02.017
DO - 10.1016/j.amjsurg.2016.02.017
M3 - Article
C2 - 27270411
VL - 212
SP - 889
EP - 895
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 5
ER -