Scripties UMCG - Rijksuniversiteit Groningen
 
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Postoperative mortality in patients aged 80 years and older

(2012) Kooistra, J. (Jolanda)

Introduction
The aging population in the Netherlands results in increasing numbers of surgical operations on patients aged 80 years and older. Former studies showed that perioperative mortality is very acceptable in this age group. However, some authors report a publication bias: only the healthy elderly patients undergo surgery. Secondly, not much is known about long-term outcome. The aim of this study was to examine how many elderly patients with an indication for surgery actually do undergo surgery. Moreover, we aimed to compare the two-year mortality rate of surgical patients with the two-year mortality rate of the general population of similar age and sex. Finally we aimed to identify predictors of mortality within two years after surgery.
Material and method:
In this single centre study we collected data of all patients aged 80 years or older who had an indication for surgery in the year 2009. Primary outcome was two-year mortality. A chi square test was used to compare the two-year mortality rate of patients who had surgery with the expected two-year mortality rate of the general population of similar age and sex. Multivariate regression analysis was used to identify predictors of two-year mortality.
Results:
Between January and December 2009 537 patients aged 80 years or older presented at our institution with an indication for surgery. Surgery was performed in 90%. Of these patients 155 (32%) died within two years after surgery. Overall mortality was significantly higher in patients who had surgery compared to the general population, but the difference in mortality between operated patients and the general population was relatively small in the age groups 80-84 and 85-89 years. Independent predictors of postoperative mortality were age (p < 0.05) and ASA classification (p < 0.001).
Conclusion:
Postoperative mortality in patients aged 80 to 90 years was acceptable and our data suggest that it is safe for patients in this age group to undergo surgery. This is consistent with the results of previous investigations. Further investigations are necessary to assess postoperative outcome in patients aged 90 years and older.





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