Surgical Outcomes for Patients Aged 80 and Older: Morbidity and Mortality from Major Noncardiac Surgery

Hamel, Mph Mary Beth; Henderson, William G.; Khuri, Shukri F.; Daley, Jennifer

doi:10.1111/j.1532-5415.2005.53159.x

Cited by 546 publications

(362 citation statements)

References 18 publications

Supporting

Mentioning

321

Contrasting

Unclassified

Order By: Relevance

“…An increasing proportion of the ageing population is undergoing surgery [1]. Despite the benefits of surgery seen in this population, the rate of adverse postoperative outcomes increases with age [2]. Postoperative complications are predominantly medical rather than surgical [3], and their increased rate is associated with physiological age [4], multimorbidity [5,6] and geriatric syndromes, including frailty [7], sarcopenia [8] and delirium [9].…”

Section: Resultsmentioning

confidence: 99%

The impact of pre‐operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review

et al. 2013

View full text Add to dashboard Cite

SummaryComprehensive geriatric assessment is an established clinical approach. It reduces mortality and improves the physical wellbeing of older people in the community or hospitalised for medical reasons. Pre-operative comprehensive geriatric assessment seems a plausible method for reducing adverse postoperative outcomes. The objectives of this systematic review and narrative synthesis are to describe how pre-operative comprehensive geriatric assessment has been used in surgical patients and to examine the impact of comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery. We searched MEDLINE, EMBASE and Web of Science from 1980 to 2013 (week 26). We included five studies: two randomised controlled trials and three before-and-after intervention quasi-experimental studies. Patient populations, interventions and outcome measures varied between studies. Both the randomised trials showed benefit on postoperative outcomes, including medical complications. Two of the before-and-after studies reported a positive impact on postoperative length of stay and other outcomes. The heterogeneity of study methods, populations, interventions and outcomes precluded meta-analysis. Based on this narrative synthesis, pre-operative comprehensive geriatric assessment is likely to have a positive impact on postoperative outcomes in older patients undergoing elective surgery, but further definitive research is required. Clinical services providing pre-operative comprehensive geriatric assessment for older surgical patients should be considered. An increasing proportion of the ageing population is undergoing surgery [1]. Despite the benefits of surgery seen in this population, the rate of adverse postoperative outcomes increases with age [2]. Postoperative complications are predominantly medical rather than surgical [3], and their increased rate is associated with physiological age [4], multimorbidity [5,6] and geriatric syndromes, including frailty [7], sarcopenia [8] and delirium [9]. Although adverse postoperative outcomes and the risk factors for developing these are well described in older surgical patients [2], a national UK report has highlighted deficiencies in the care provided to this patient population [10]. Furthermore, pre-operative assessment has not been adapted to identify and modify these geriatric syndromes and multi-morbidity 8

show abstract

Section: Resultsmentioning

confidence: 99%

The impact of pre‐operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review

et al. 2013

View full text Add to dashboard Cite

show abstract

“…3 However, due to the concerns of postoperative complications and mortality, there are many difficulties in decision of surgical treatment. 4,5 In this study, we divided the middle old (70~79) group and the very old (≥80) group to compare postoperative complica-tions and the survival rate between the two groups.…”

Section: Introductionmentioning

confidence: 99%

Complications and Survival Rate of Patients Over 80 Years Old Who Underwent Laparoscopic Gastrectomy for Gastric Cancer

Kim

Lee

Choi

et al. 2017

J Minim Invasive Surg

View full text Add to dashboard Cite

Purpose:As the life expectancy increases, the population of elderly patients increases. We evaluated the complications and survival rate of patients over 80 years old, who underwent laparoscopic gastrectomy.Methods: A retrospective analysis was conducted for a total of 1,912 patients, who underwent surgery with stomach cancer from 2008 to 2016. We analyzed postoperative complications and the survival rate between the middle old (70~79, n=255) group and the very old (≥80, n=37) group.Results: Among 1,912 patients, 255 people in the middle old group and 37 people within the very old group underwent laparoscopic gastrectomy. We confirmed that there was no significant difference except for the age (p<0.001) between the two groups. Overall complications were not statistically significantly different between the Middle old (70~79) group and the very old (≥80) group, 11.8% and 16.2%, respectively. There were also no statistically significant differences in severe complications beyond Clavien-Dindo classification Grade III. Risk factors for overall complications were higher in males than in females (p=0.002). Overall survival was statistically significantly lower with very old group (p<0.001).Conclusion: Laparoscopic gastrectomy in gastric cancer patients over 80 years of age is feasible and safe in terms of complications. However, considering the life expectancy, it seems necessary to pay attention to the patients who apply surgery.

show abstract

“…Two large US studies 5,6 as well as one large Australian study 7 have shown increased morbidity and mortality in older surgical patients. Interestingly, risk factors plateau at age 60, but surgical morbidity and mortality continues to increase linearly with age.…”

Section: Surgical Outcomesmentioning

confidence: 99%

Pancreatic Cancer in the Very Elderly Patient: Challenges and Solutions

Bellevue¹,

Johnson²,

Feczko³

et al. 2016

Surg Res Open J

View full text Add to dashboard Cite

Pancreatic cancer is responsible for a significant disease burden on the aging US population. The only chance at curing this highly morbid disease is surgical resection, however choosing appropriate surgical candidates in the elderly population remains challenging. We review the literature for appropriate treatment modalities to the elderly patient. Although significant literature exists in choosing appropriate surgical candidates as well as managing those not deemed fit for surgery, the medical community is not unified when approaching these patients. Further collaboration between the surgical, medical, and palliative communities will likely spawn better outcomes for less overall health care cost in the future.

show abstract

Surgical Outcomes for Patients Aged 80 and Older: Morbidity and Mortality from Major Noncardiac Surgery

Abstract: A substantial minority of patients aged 80 and older died or suffered a complication within 30 days of surgery, but for many operations mortality rates were extremely low. Postoperative complications were associated with high 30-day mortality in patients aged 80 and older.

Cited by 546 publications

References 18 publications

The impact of pre‐operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review

The impact of pre‐operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review

Complications and Survival Rate of Patients Over 80 Years Old Who Underwent Laparoscopic Gastrectomy for Gastric Cancer

Pancreatic Cancer in the Very Elderly Patient: Challenges and Solutions

Contact Info

Product

Resources

About