Age ≥65 years was an independent risk factor for 30-day postoperative mortality following major digestive surgery (OR 2.21; 95% CI 1.36-3.59; P=0.001).
Cohort (n=3,322)
Yes
What are the independent risk factors for 30-day postoperative mortality in elderly patients undergoing major digestive surgery?
Odds Ratio: 2.21 (95% CI 1.36–3.59)
p-value: p=0.001
OBJECTIVE: To identify the mortality risk factors of elderly patients (≥65 years old) during major digestive surgery, as defined according to the complexity of the operation. BACKGROUND: In the aging populations of developed countries, the incidence rate of major digestive surgery is currently on the rise and is associated with a high mortality rate. Consequently, validated indicators must be developed to improve elderly patients' surgical care and outcomes. METHODS: We acquired data from a multicenter prospective cohort that included 3322 consecutive patients undergoing major digestive surgery across 47 different facilities. We assessed 27 pre-, intra-, and postoperative demographic and clinical variables. A multivariate analysis was used to identify the independent risk factors of mortality in elderly patients (n = 1796). Young patients were used as a control group, and the end-point was defined as 30-day postoperative mortality. RESULTS: In the entire cohort, postoperative mortality increased significantly among patients aged 65-74 years, and an age ≥65 years was by itself an independent risk factor for mortality (odds ratio OR, 2.21; 95% confidence interval CI, 1.36-3.59; P = 0.001). The mortality rate among elderly patients was 10.6%. Six independent risk factors of mortality were characteristic of the elderly patients: age ≥85 years (OR, 2.62; 95% CI, 1.08-6.31; P = 0.032), emergency (OR, 3.42; 95% CI, 1.67-6.99; P = 0.001), anemia (OR, 1.80; 95% CI, 1.02-3.17; P = 0.041), white cell count > 10,000/mm³ (OR, 1.90; 95% CI, 1.08-3.35; P = 0.024), ASA class IV (OR, 9.86; 95% CI, 1.77-54.7; P = 0.009) and a palliative cancer operation (OR, 4.03; 95% CI, 1.99-8.19; P < 0.001). CONCLUSION: Characterization of independent validated risk indicators for mortality in elderly patients undergoing major digestive surgery is essential and may lead to an efficient specific workup, which constitutes a necessary step to developing a dedicated score for elderly patients.
Duron et al. (Tue,) conducted a cohort in major digestive surgery (n=3,322). Age ≥65 years vs. Young patients was evaluated on 30-day postoperative mortality (OR 2.21, 95% CI 1.36-3.59, p=0.001). Age ≥65 years was an independent risk factor for 30-day postoperative mortality following major digestive surgery (OR 2.21; 95% CI 1.36-3.59; P=0.001).