Surgical Experience in the Aged as an Aid to Surgery in the Young†

Abstract

Most discussions on surgery of the aged deal first with the increasing incidence of, and need for operation in older patients, and second, with the reduced mortality now experienced in this group. As an example of the latter, at the Barnes Hospital during a one-year period , 714 surgical procedures were carried out in patients aged 70 to 96; death occurred in 27-a mortality rate of 5.5 per cent. There was a similar mortality rate in 239 procedures listed as general surgery; 12 patients died. However, on breaking down these figures into elective procedures, it was found that in 107 cases the following operations were carried out: hernia in 28, gastrectomy in 13, amputation in 18, sigmoid resection in 10, radical mastectomy in 15, and cholecystectomy in 13. There was only 1 deathin a patient operated upon for gallbladder disease but in whom extensive carcinoma was found.The present communication deals with an inquiry into the causes for the reduced mortality in geriatric surgery during the past decade or two and how this knowledge has been applied to surgery in the younger patient. For convenience, these advances in surgical therapy may be partly classified into six arbitrary groups.

Mortality in Elderly Patients After Anesthesia and Operation

“…Forastiere (6) from the Bellevue Hospital, New York City, also reported a mortality of 3.2 per cent. Corssen (7) from the University of Texas noted a 5.5 per cent mortality, as did Elman of Barnes Hospital, St. Louis (8). Hingson (9) from Western Reserve University has a low mortality of 2.6 per cent.…”