Impact of Comorbidities and COVID-19 on the Survival Rate of Geriatric Patients Receiving Anesthesia Services: A Prospective Cohort Study in Indonesia

Abstract

Background As life expectancy increases, the worldwide population aged 60 years and older increases year by year. Consequently, more older people receive medical attention, especially those who undergo surgery. In addition, the COVID-19 pandemic has had a global impact on elderly patients, especially those undergoing surgery. This study aims to describe the characteristics and analyze the survival rate of elderly patients who receive anesthesia services, especially those with comorbidities and COVID-19. Methods A prospective cohort study at 14 central hospitals in Indonesia analyzed 1621 elderly patients (67.1 ± 6.2 years old). The variables that were recorded included patient characteristics, comorbidities, the COVID-19 status, and the survival rate, including 30-day mortality. Results The 30-day mortality was 4.4%. The most comorbidity was hypertension (30.0). Patients with a Charlson's Comorbidity Index Score of 3-4 had a higher death rate (15.3%). The highest mortality rates were in the patients who had dementia, rheumatologic disease, liver disease, previous myocardial infarction, and diabetes with chronic complications as comorbidities. The percent of patients with COVID-19 who died was 26.6%. Patients with several comorbidities and COVID-19 had a lower survival rate than those without (log-rank p<0.05) Conclusion Approximately four in ten elderly patients receiving anesthesia died, and the percent increased when the patients had comorbidities and COVID-19.