Operative and prognostic parameters associated with elective versus emergency surgery in a retrospective cohort of elderly patients

Soyalp, Celaleddin; Yüzkat, Nureddin; Kılıç, Mehmet; Akyol, Mehmet Edip; Demir, Cansun; Gülhaş, Nurçin

doi:10.1007/s40520-018-0976-z

Cited by 13 publications

(13 citation statements)

References 21 publications

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“…We found that comorbidity, advanced TNM-stages, and emergency surgery had profound negative effects on the 100-day mortality. These associations were consistent with those demonstrated in previous reports [34,35]. We noted a 50% reduction in the overall 100-day mortality rate, between the rst and last decades of the observational period.…”

Section: All Patientssupporting

confidence: 93%

Octogenarian Patients with Colon Cancer – Postoperative Morbidity and Mortality are the Major Challenges

Høydahl

Edna

Xanthoulis

et al. 2021

Preprint

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Background Few studies have addressed colon cancer surgery outcomes in an unselected cohort of octogenarian patients. The present study aimed to evaluate the relative survival of octogenarian patients after a major resection of colon cancer with a curative intent. Methods All patients diagnosed with colon cancer at Levanger Hospital between 1980 and 2016 were included. We performed logistic regression to test for associations between 100-day mortality and explanatory variables. We performed a relative survival analysis to identify factors associated with short- and long-term survival.Results Among 239 octogenarian patients treated with major resections with curative intent, the 100-day mortality was 10.1%. Among 215 patients that survived the first 100 days, the five-year relative survival rate was 99.7%. The 100-day mortality of octogenarian patients was significantly shorter than that of younger patients, but the long-term survival converged with that of younger patients. Among octogenarian patients, the incidence of colon cancer more than doubled during our 37-year observation period. The relative increase in patients undergoing surgery exceeded the increase in incidence; hence, more patients were selected for surgery over time. A high 100-day mortality was associated with older age, a high American Society of Anaesthesiologists (ASA) score, and emergency surgery. Moreover, worse long-term survival was associated with a high Charlson Comorbidity Index, a high ASA score, a worse TNM stage, emergency surgery and residual tumours. Both the 100‑day and long-term survival rates improved over time. Conclusion Among octogenarian patients with colon cancer that underwent major resections with curative intent, the 100-day mortality was high, but after surviving 100 days, the relative long-term survival rate was comparable to that of younger patients. Further improvements in survival will primarily require measures to reduce the 100-day mortality risk.

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Section: All Patientssupporting

confidence: 93%

Octogenarian Patients with Colon Cancer – Postoperative Morbidity and Mortality are the Major Challenges

Høydahl

Edna

Xanthoulis

et al. 2021

Preprint

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“…Moreover, comorbidities cannot be optimised in the emergency setting. Therefore, acute surgeries pose a risk factor for the older patients, including significantly higher morbidity and mortality rate in comparison with the elective operations [28]. Introduction of frailty screening and other geriatric surgery concepts may be an option for further outcome improvement.…”

Section: Discussionmentioning

confidence: 99%

Indications for Emergency Abdominal Surgeries in Older Patients: 7-Year Experience of a Single Centre

et al. 2020

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The majority of patients undergoing emergency laparotomy are older adults that carry the highest mortality. More research into the development of targeted interventions is required. Therefore, the aim of the study was to analyse the indications for emergency abdominal surgery in patients aged ≥ 65 admitted to the Department of General Surgery. The study included consecutive patients aged ≥ 65 who underwent emergency abdominal surgery within 48 h after admission at one institution. In 2010-2017, 986 patients were enrolled in the study (female 57%, male 43%). Patients were divided into three age groups, 65-70, 71-84 and ≥ 85, with 255 patients (25.9%), 562 patients (57.0%) and 169 patients (17.1%) in each group, respectively. In the first and second age groups, the most common indications for surgery were acute cholecystitis, non-malignant ileus, colorectal cancer complications and acute appendicitis. In the oldest patients, the most common indications were complications of colorectal cancer, acute cholecystitis, nonmalignant ileus and complications of diverticulosis. In the women, the biggest differences in indications between age groups were colorectal cancer (p = 0.025) and peptic ulcer disease complications (p = 0.005); in the men, the biggest difference was seen for complicated diverticulitis (p = 0.001). The most frequent comorbidities were heart diseases (81.0%), followed by endocrine (33.6%) and vascular diseases (22.7%). The three most common indications for emergency surgery in older patients at our institution were acute cholecystitis, colorectal cancer complications and non-malignant bowel obstruction, affecting 59.5% of this group of patients. Elective surgery and endoscopic screening have the potential to prevent major part of these acute diseases. However, further prospective research is necessary on this field, particularly among frail, older patients.

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“…In their studies, Jiang et al and Soyalp et al stated that advanced age was associated with higher risk of mortality [6][7]. Li et al found increased anesthesia-related mortality in patients aged 75 years and above [8].…”

Section: Discussionmentioning

confidence: 97%

The Effect of Increased Neutrophil Lymphocyte Ratio on Mortality in Patients Operated on Due to Hip Fracture

Atlas

Duran

Pehlivan

et al. 2020

Cureus

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In this study, we aimed to examine the effect of neutrophil-lymphocyte ratio (NLR) on mortality and morbidity in elderly patients over the age of 65 who presented to our clinic and were operated on due to hip fracture. Methods The study included patients over the age of 65 who were operated on in our hospital between January 2014 and December 2018 due to hip fracture. Those with multiple fractures and those who were operated on due to cancer-related fracture were excluded. Patients' age, gender, American Society of Anesthesiologists (ASA) score, preoperative waiting time, type of anesthesia, operation duration, amount of erythrocyte suspension used, and duration of intensive care unit (ICU) stay were recorded. The effect of increased preoperative and postoperative 5th day neutrophil-lymphocyte ratios (NLR 1 and NLR 5, respectively) on mortality and morbidity was investigated. Results We examined 132 patients operated on due to hip fracture. NLR 5 was higher among patients who were admitted to the ICU (p = 0.007) and among those who died (p = 0.007). Additionally, the rate of increase of NLR 5 was higher among patients who were admitted to the ICU (p = 0.044) and among those died (p = 0.009). Conclusion The rate of increase of NLR in the postoperative period can be used as a criterion for predicting mortality in patients who are operated on due to hip fracture.

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Operative and prognostic parameters associated with elective versus emergency surgery in a retrospective cohort of elderly patients

Cited by 13 publications

References 21 publications

Octogenarian Patients with Colon Cancer – Postoperative Morbidity and Mortality are the Major Challenges

Octogenarian Patients with Colon Cancer – Postoperative Morbidity and Mortality are the Major Challenges

Indications for Emergency Abdominal Surgeries in Older Patients: 7-Year Experience of a Single Centre

The Effect of Increased Neutrophil Lymphocyte Ratio on Mortality in Patients Operated on Due to Hip Fracture

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