Operative Risk Factors of Colon Resection in the Elderly

Boyd, Jonathan; Bradford, B; Watne, Alvin L.

doi:10.1097/00000658-198012000-00009

Cited by 133 publications

(47 citation statements)

References 4 publications

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“…Weight loss and obstructive conditions were perceived to negatively impact short-term outcomes, as well as a number of medical conditions such as cardiovascular, pulmonary, renal, hepatic, and metabolic conditions [8][9][10][11].…”

Section: Comprehensive Geriatric Assessmentmentioning

confidence: 99%

“…There is considerable evidence that this steadily expanding population receives substandard treatment when compared with younger age groups [4]. Possible explanations that have been suggested for this inequity in treatment include A) the perceived limitations to conventional treatments in the elderly [5,6]; B) concerns about attendant serious associated medical conditions [7,8], and C) a reluctance by clinicians to incorporate older patients either into clinical trials of novel agents or into existing screening programs [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Assessment of Surgical Risk in Oncogeriatric Patients

et al. 2005

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Cancer is a prevalent disease in our aging population; however, few oncologists are familiar with caring for oncogeriatric patients. Surgery is presently the treatment of choice for most solid tumors, but it is frequently delivered in a suboptimal way in this patient subsetting. Undertreatment is often justified with the concern of an unsustainable toxicity, while overtreatment can be related to the lack of knowledge in optimizing preoperative risk assessment. To draw new light on this issue, several surgeons presented their series, providing hard evidence that surgical options can be offered to the elderly with cancer, with only a limited postoperative mortality and morbidity. As it is likely that much of these data suffer from selection bias, we concentrated on Comprehensive Geriatric Assessment (CGA), which can add substantial information on the functional assessment of elderly cancer patients. A validated instrument such as the CGA allows a comparison of series, predicting short-term surgical outcomes more precisely, and offers appropriate information when consenting elderly patients. Preoperative Assessment of Cancer in the Elderly is a prospective international study conceived and launched to outline the fitness of elderly surgical patients with malignant tumors. This paper reports on preliminary results and analysis from the ongoing study. The Oncologist 2005;10:262-268

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Section: Comprehensive Geriatric Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preoperative Assessment of Surgical Risk in Oncogeriatric Patients

et al. 2005

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“…One series reported an incidence of 45% of patients 70 years and over and a 100% incidence in the 80 year and over group. 9 Boyd et al 2 in studying colon resection in the elderly reported cardiovascular disease in 57% of patients aged 70 to 79 years and in 85% of those 80 years and over.…”

Section: Major Complicating Systemic Diseases Cardiovascular Diseasementioning

confidence: 99%

“…2 These workers believe that the role of the complicating disease processes is more significant than increasing age.…”

Section: Increasing Agementioning

confidence: 99%

“…United States population statistics (Table 1) indicate an estimated 10-fold increase in the number of people over 65 years old in this century. 2 Major disorders requiring surgery are commonly seen in this age group, as are the degenerative disease processes that often complicate the preoperative, intraoperative and postoperative course. The operative mortality in the elderly undergoing surgery under anesthesia is a significant health care Problem that needs evaluation.…”

Section: Introductionmentioning

confidence: 99%

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A Review of Risk Factor in the Elderly Candidate for Surgery and Anesthesia

Davies

1983

Ann Saudi Med

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The proportion of elderly people in the population has markedly increased in this century, leading to an increase in the number of elderly patients undergoing surgery and anesthesia. However, the special problems posed by surgery and anesthesia in the elderly have received little attention in the current anesthesiology literature; most of the existing information comes from the fields of surgery, internal medicine, and geriatrics. There appears to be a good correlation between operative mortality in the aged and the physical status classification developed by the American Society of Anesthesiologists. Among the few studies in this area, one found that in patients with a mean age of 75 years, postoperative mortality was 6% for those in Class 2, 20% in Class 3, and 58% in Class 4. A more recent study of patients with a mean age of 68 years indicated that postoperative mortality was 6% in Class 2, 12% in Class 3, and 22% in Class 4. This study also suggests that for patients with uncorrectable advanced functional deficits, cancellation or modification of surgery should be considered and local rather than general anesthesia used. Emergency surgery in the aged may be particularly hazardous; available data indicate that between 25% and 33% of elderly patients die following emergency surgery and anesthesia. Additional risks include advanced age, malnutrition, overt psychoses and dementia, and complicating systemic diseases, particularly those of the cardiovascular system. The duration of the surgical procedure is considered by some to affect the outcome, whereas the sex of the patient may be a factor only in certain specific operations. Surgery and Anesthesia. 1983; 3(3): 179-184 G Davies, A Review of Risk Factor in the Elderly Candidate for

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Outcomes of Ostomy Procedures in Patients Aged 70 Years and Older

Bosshardt¹

2003

Arch Surg

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Hypothesis: Patients aged 70 years and older undergo proportionately more emergency and permanent fecal ostomy procedures than younger patients. Older patients have comparable short-term outcomes in morbidity and mortality, with adverse outcomes dependent on comorbid conditions and timing of the procedure rather than age alone. Older patients should be treated similarly to younger patients in terms of subsequent ostomy takedown, if an acceptable operative risk. Design: A retrospective review of our facility's experience with fecal ostomies between 1992 and 2002 was performed to determine the effect of advanced age on surgical outcome measures. Setting: A tertiary managed care medical center. Patients: Three hundred eighty-three consecutive patients who underwent new fecal ostomy procedures between October 1, 1992, and October 1, 2002. One hundred three patients were aged 70 years or older (mean age, 76.4 years), and 280 patients were younger than 70 years (mean age, 49.6 years). There were 220 elective procedures and 163 emergency procedures. Outcome was analyzed between the 2 age groups. Main Outcome Measures: Indications for ostomy, type of ostomy, preoperative comorbidity, postoperative morbidity and mortality, length of intensive care unit and hospital stay, and subsequent ostomy takedown success.

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Operative Risk Factors of Colon Resection in the Elderly

Cited by 133 publications

References 4 publications

Preoperative Assessment of Surgical Risk in Oncogeriatric Patients

Preoperative Assessment of Surgical Risk in Oncogeriatric Patients

A Review of Risk Factor in the Elderly Candidate for Surgery and Anesthesia

Outcomes of Ostomy Procedures in Patients Aged 70 Years and Older

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