In patients aged 85 and older undergoing abdominal surgery, ASA score and premorbid residential status are more important predictors of mortality and complications than age itself.
ASA score and premorbid status may better inform risk discussions than age in patients ≥85 years undergoing abdominal surgery; leaves open prospective validation.
OBJECTIVES: To review the outcomes of patients aged 85 and older after abdominal surgery in terms of mortality, morbidity, and change in residential status and to analyze factors predicting such outcomes. DESIGN: Retrospective clinical cohort study. SETTING: A tertiary regional hospital in Victoria, Australia. PARTICIPANTS: One hundred seventy-nine patients aged 85 and older who had abdominal surgery between 1998 and 2008. MEASUREMENTS: Mortality, complications (morbidity), and change in residential status. RESULTS: The patient sample had a mean age of 88.6, a mortality rate of 17.3%, and a morbidity rate of 62.8%. Approximately two-thirds (64%) of all abdominal surgeries were emergency surgeries. Factors predicting mortality included American Society of Anesthesiologists (ASA) score and premorbid residential status. Risk factors predicting severity of complications were ASA score and emergency surgery. Significant factors contributing to change in residential status were ASA score and severity of complications. Age, sex, and number of comorbidities were not significant factors. CONCLUSION: Patients aged 85 and older experienced mortality rates of 17.3% after abdominal surgery. ASA score and premorbid residential status appear to be more important than age in determining risk for abdominal surgery in older persons.
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Mirbagheri et al. (2010) studied this question.
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