SEATTLE — Elderly persons who undergo major bowel operations on an elective basis fare much better than those who have emergency surgery, Dr. Demetrios J. Louis said at the annual meeting of the American Society of Colon and Rectal Surgeons.
Dr. Louis reviewed 138 patients over the age of 80 years who underwent major intestinal operations at Rush University Medical Center, Chicago, between 1995 and 2005. Overall, 53% of the 138 patients had surgical complications and the mortality rate was 8%. He found much higher rates of complications, morbidity, and mortality in those who had the emergent procedures than in those who had elective procedures. For instance, their length of hospital stay was 2.7 times longer (21 days average versus 8 days), their major complication rate was more than twice as high (81% versus 35%), and their mortality rate was more than 16 times higher (32% versus 2%).
Patients who underwent emergency procedures tended to have significantly worse American Society of Anesthesiologists (ASA) status.
The findings suggest that success in older individuals is determined primarily by ASA status and the need for emergency surgery and, therefore, that “absolute age is not a determinant in outcome,” said Dr. Louis, of the department of general surgery at Rush University.