Outcomes of Surgery in Patients 90 Years of Age and Older

Abstract

During the 11-year period 1975 through 1985, seven hundred ninety-five patients 90 years of age and older underwent operative procedures at the Mayo Clinic, Rochester, Minn. Overall serious morbidity within 48 hours after surgery was 9.4%, and the mortality was 1.6%. The 30-day, 1-year, and 5-year mortality rates were 8.4%, 31.4%, and 78.8%, respectively. Short-term morbidity and both short- and long-term mortality were highly associated with the American Society of Anesthesiologists physical status classification of the patient. Emergency procedures carried a significantly higher risk for morbidity and mortality within the 48-hour period and, to a lesser extent, for long-term mortality. Overall, poorer patient survival was associated with higher American Society of Anesthesiologists class; male sex; preoperative renal, liver, and central nervous system impairment; and surgery on the mouth, nose, or pharynx. When compared with age-, sex-, and calendar year--matched peers from the general population, there was a modest decrease in patient survival at 1 year that reversed by 2 years, with observed survival at 5 years comparable to the rate expected.

Pancreatoduodenectomy for Ductal Adenocarcinoma in the Very Elderly; Is It Safe and Justified?

“…Interestingly, outcomes of all types of surgery (not specific to cancer) in those aged 90 and above have also reported to be encouraging, 12 making the point that chronologic age should not be the sole determinant of operative candidacy. Still, major operative procedures with such a great morbidity (40-50% for PD) should be analyzed critically for acceptable outcomes in a group of patients whose expected survival from all causes other than the underlying pancreatic cancer is limited, in our case, patients greater than 80 years of age.…”

Characteristics of Emergency Pages Using a Computer-Based Anesthesiology Paging System in Children and Adults Undergoing Procedures at a Tertiary Care Medical Center

“…10 Data abstracted included demographics, ASA Physical Status score, specific comorbidities, intraoperative and postoperative events and major outcomes. Comorbid conditions were defined according to criteria previously used for outcome studies at Mayo Clinic 11 and include cardiovascular, peripheral vascular, and respiratory diseases; diabetes mellitus; and neurologic conditions (e.g., stroke, developmental delay). The anesthetic record was reviewed for type of anesthesia (combination regional and general anesthetics were considered general anesthetics) and type of in-room anesthesia provider (certified registered nurse anesthetist [CRNA], student registered nurse anesthetist [SRNA], or anesthesia resident physician).…”

Krebsvorsorgeuntersuchungen bei älteren Patientinnen

“…Be rück sich tigt man da rü ber hi naus, dass die Mor ta li tät im Rah men ei nes ope ra tiven Ein griffs ei ner über 90-jäh ri gen Pa tien tin in den 1960er-Jah ren [11] noch über 29 und heu te we ni ger als 9 be trägt, so wird klar, dass die im An schluss an eine Krebs früh er ken nung ggf. not wen di ge thera peu ti sche Maß nah me we sent lich we niger ri si ko reich durch zu füh ren ist und im Ver gleich zum Le bens er war tungs ge winn ab so lut ver tret bar er scheint.…”