Predictors of in-hospital mortality amongst octogenarians undergoing emergency general surgery: a retrospective cohort study
Iain Wilson, Michael Paul Barrett, Ashish Sinha, Shirley Chan, Iain Wilson, Michael Paul Barrett, Ashish Sinha, Shirley Chan
Abstract
Introduction: Elderly patients are often judged to be fit for emergency surgery based on age alone. This study identified risk factors predictive of in-hospital mortality amongst octogenarians undergoing emergency general surgery.
Methods: A retrospective review of octogenarians undergoing emergency general surgery over 3 years was performed. Parametric survival analysis using Cox multivariate regression model was used to identify risk factors predictive of in-hospital mortality. Hazard ratios (HR) and corresponding 95% confidence interval were calculated.
Results: Seventy-three patients with a median age of 84 years were identified. Twenty-eight (38%) patients died post-operatively. Multivariate analysis identified ASA grade (ASA 5 HR 23.4 95% CI 2.38-230, p = 0.007) and chronic obstructive pulmonary disease (COPD) (HR 3.35 95% CI 1.15-9.69, p = 0.026) to be the only significant predictors of in-hospital mortality.
Conclusions: Identification of high risk surgical patients should be based on physiological fitness for surgery rather than chronological age.
Keywords: Emergency; General surgery; Mortality; Octogenarian.
Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Source: PubMed