Abdominal surgery in patients 90 years of age and older at a provincial general hospital

Authors: Hideyuki Ichikawa; Shiro Hayashi

Source: Geriatrics and Gerontology International, Volume 4, Number 3, September 2003 , pp. 184-191(8)

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Abstract:

Background:

It has been commonly accepted that age itself is never an absolute contraindication for surgical treatment in the elderly. Some of the many problems with the oldest old could be solved by surgical intervention. However, there are quite a few issues to be resolved for the surgical treatment of patients aged in their nineties. We therefore investigated cases of abdominal operations performed during the past decade, and wish to give our point of view on the indication, significance, merits and demerits of conducting surgical operations in this age-group of patients. Methods:

We studied perioperative status, postoperative morbidity/mortality, and short- and long-term outcomes of abdominal surgery in patients 90 years of age and older who underwent abdominal surgical operation at a provincial general hospital. Results:

Seven patients had elective operations and six patients underwent emergency operations. The postoperative morbidity was fairly high after both elective and emergency operations. Major complications occurred in one patient who died of multiple organ failure 20 days after the operation. One patient stayed in the hospital and died there 240 days after gastrectomy. Three patients survived more than 4 years after surgery. No definite relationship was revealed between the risk score and postoperative morbidity/mortality. No evident change was recognized in the performance status in patients who received abdominal surgical operations. Conclusion:

The results indicate that more meticulous consideration as well as more precise decision about the indication for surgical intervention, and more intensive perioperative management will be necessary in order to secure more favorable outcomes of therapy and quality of life for high-risk patients aged in their nineties.

Keywords: abdominal surgery; elderly patients; postoperative survival rate

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1447-0594.2004.00247.x

Affiliations: 1: Tokyo Metropolitan Tama Geriatric Hospital, Tokyo, Japan

Publication date: 2003-09-01

Abdominal surgery in patients 90 years of age and older at a provincial general hospital

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