Post-Surgical Risks Highest in Older Adults
WEDNESDAY Dec. 23, 2009 -- The approximately 2 million older adults who undergo common abdominal operations each year are at higher risk than others of suffering complications and early death, researchers find.
Little was known about the specific risks facing people 65 and older, the researchers said. "For clinicians, patients and families considering abdominal surgical procedures, informed decision making is challenging because of limited data regarding the risks of adverse perioperative events associated with advancing age," they write in the December issue of Archives of Surgery.
The researchers, from the University of Washington School of Medicine in Seattle, examined medical records of 101,318 adults age 65 or older who underwent abdominal procedures from 1987 to 2004. The operations included cholecystectomy (gall bladder removal), hysterectomy, colectomy and other procedures.
Of the patients, 17.3 percent had complications within 90 days and 5.4 percent died. As patients got older, so did the rate of complications and deaths -- to 22.7 percent and 16.7 percent, respectively, for those 90 and older.
"After adjusting for demographic, patient and surgical characteristics as well as hospital volume, the odds of early postoperative death increased considerably with each advance in age category," the researchers wrote. "These associations were found among patients with both cancer and noncancer diagnoses and for both elective and nonelective admissions.
"Older adults may be less able to adapt to the stress of surgery or to the added stress of any postoperative complication, greatly increasing their risk of early mortality," the researchers added. "These effects appear to be additive, highlighting the need for interventions to both prevent decline among older patients and avoid postsurgical complications."
Learn about safe surgery from the Agency for Healthcare Research and Quality.
Posted: December 2009