Key result
Living alone, ECG abnormality, comorbidity > 2, hypoalbumin, and ASA > 2 were significantly associated with in-hospital mortality in geriatric patients after elective surgery (p<0.0001).
Why the study?
The increased number of surgeries in elderly patients is often accompanied by an increased risk of mortality, making the identification of surgical death risk factors crucial before decision-making.
Cohort (n=382)
No
p-value: p=<0.0001
Living alone, ECG abnormalities, high comorbidity burden, hypoalbuminemia, and high ASA score are significant predictors of in-hospital mortality in geriatric patients undergoing elective surgery.
May support preoperative risk stratification in geriatric elective surgery; leaves open need for prospective validation before practice change.
Introduction: The increased number of surgery on the elderly is often followed by an increased risk of mortality rate. Identifying the risk factors of surgical death in elderly patients will be mandatory before making a decision. This study aimed to determine mortality-associated factors in older people who underwent inpatient elective surgery. Methods: This cohort retrospective study analyzed secondary data from the medical records of geriatric patients hospitalized at Dr. Kariadi Hospital Semarang in 2020. Patients aged ≥ 60 years and who have undergone elective surgery were included. Patients with incomplete medical records, who had undergone outpatient surgery, more than one surgery, and emergency surgery, Covid-19, were excluded. A total of 382 patients met the criteria. In this study, independent variables analyzed were age, sex, nutritional status based on body mass index, functional status by Barthel, marital status, residence status, number of comorbidities according to Charlson Comorbidity Index, albumin levels, electrocardiogram (ECG) abnormalities, surgery type, and American Society of Anesthesiologists (ASA) status. The dependent variable was in-hospital mortality. In the logistic regression analysis, we identified the five most significant variables to allow for the prediction of in-hospital mortality. Results: Residence status (p= 0.003), ECG (p= 0.001), comorbidity (p <0.0001), albumin status (p< 0.0001), and ASA status (p< 0.0001) were identified as factors that affect postoperative mortality after multivariate analysis. Conclusion: In this study, mortality-associated factors were living alone, ECG abnormality, comorbidity > 2, hypoalbumin, and ASA > 2.
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Mupangati et al. (2023) conducted a cohort in geriatric patients after elective surgery (n=382). Living alone, ECG abnormality, comorbidity > 2, hypoalbumin, and ASA > 2 was evaluated on In-hospital mortality (p=<0.0001). Living alone, ECG abnormality, comorbidity > 2, hypoalbumin, and ASA > 2 were significantly associated with in-hospital mortality in geriatric patients after elective surgery (p<0.0001).
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