Mortality and Complication Rates After Emergency Abdominal Surgery: A Retrospective Analysis in Geriatric Age Groups

Aim: The growing geriatric population faces high morbidity and mortality after emergency abdominal surgery. While age is often regarded as a risk factor, whether chronological age itself or accompanying perioperative variables primarily drive adverse outcomes remains debated. Material and Methods: Patients aged ≥65 years who underwent emergency abdominal surgery at Düzce University between 2015 and 2024 were retrospectively analyzed. Patients were stratified into three age groups (65–74, 75–84, ≥85 years). Demographic, clinical, perioperative, and postoperative data were collected. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: A total of 98 patients were included (65–74 years, n=45; 75–84 years, n=35; ≥85 years, n=18). The overall 30-day mortality rate was 14.3%, with subgroup rates of 15.6%, 20.0%, and 16.7%, respectively. Postoperative complications occurred in 29 patients (29.6%), and 34 patients (34.7%) required ICU admission. In multivariable analysis, advancing age, higher ASA score, and prolonged operative time were independently associated with increased mortality risk, whereas comorbidity burden showed only a borderline effect. Conclusion: Emergency abdominal surgery in geriatric patients is associated with substantial morbidity, ICU utilization, and mortality. Although age contributed to mortality risk, its effect was modest and closely interrelated with ASA status and operative duration. A comprehensive assessment that incorporates both chronological age and perioperative factors is essential for accurate risk stratification and optimal perioperative care in this vulnerable population.