What question did this study set out to answer?

To assess perioperative morbidity, mortality, and recovery outcomes among patients aged 90 years and older undergoing major general surgical interventions.

September 1, 2000The American Surgeon

Surgery in the Nineties

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Why the study?

What are the mortality and morbidity rates associated with major general surgical procedures in nonagenarians?

Population

32 patients ≥90 years of age who underwent general surgical procedures at UCLA Medical Center since 1986…

Design

Cohort

Follow-up

perioperative

Authors

DRDavid A. RigbergVA Greater Los Angeles Healthcare System MCMichael ColeUniversity of Michigan DHDaryl HiyamaUCLA Medical Center

Discussion

Member takes

Implication

Supports elective decision-making in selected nonagenarians; leaves open need for larger prospective studies on outcomes and selection.

Key Points

To assess perioperative morbidity, mortality, and recovery outcomes among patients aged 90 years and older undergoing major general surgical interventions.
Retrospective chart review of consecutive patients aged 90 years or older (N=32) undergoing general surgical procedures at UCLA Medical Center since 1986 with no exclusions.
Evaluation of patient comorbidities, indication types (emergency vs. elective), ICU length of stay, and postoperative discharge disposition.
Overall perioperative mortality was 9.4% (3 of 32) and overall morbidity was 57%, with a mean intensive care unit stay of 4.8 days.
Elective surgical procedures demonstrated 0% mortality and 20% morbidity, whereas emergency operations (69% of cases, n=22) accounted for all deaths (13.6% mortality) and 68% morbidity.

Structured PICO

What are the mortality and morbidity rates associated with major general surgical procedures in nonagenarians?

Population

32 patients ≥90 years of age who underwent general surgical procedures at UCLA Medical Center since 1986, with 87.5% having significant premorbid conditions.

Intervention

Major general surgical operative procedures (elective and emergency)

Outcome

Perioperative mortalityhard clinical

Elective general surgery in nonagenarians is safe with 0% mortality, while emergency procedures carry an acceptable 13.6% mortality risk despite significant comorbidities.

Cite This Study

Rigberg et al. (2000) studied this question.

synapsesocial.com/papers/6a912b509732cc92acd2c2b2 https://doi.org/10.1177/000313480006600902

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Surgery in the Nineties

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Surgery in the Nineties

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider