Perioperative considerations in nonagenarians

Figures

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  Fig. 1. A, Proportion of emergent and elective cases grouped by patient age under or over 95 years; P value <.0001. Emergent cases under 95 years old, n = 281; over 95 years old, n = 68. Elective cases under 95 years old, n = 192; over 95 years old, n = 14. B, Proportion of patients able to return to prior level of function grouped by patient age under or over 95 years; P value = .0062. Patients under 95 years old unable to return to prior function, n = 320; over 95 years old, n = 65. Patients under 95 years old able to return to prior function, n = 138; over 95 years old, n = 16. C, Proportion of patients dead and alive at time of discharge grouped by patient age under or over 95 years; P value < .0001. Patients under 95 years old dead at time of discharge, n = 14; over 95 years old, n = 8. Patients under 95 years old alive at time of discharge, n = 459; over 95 years old, n = 74.

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  Fig. 2. A, Proportion of emergent and elective cases grouped by patient ASA score; P value <.0001. Number of emergent cases in ASA 1–4, respectively: 0, 22, 247, and 80. Number of elective cases in ASA 1–4, respectively: 1, 15, 142, and 48. B, Proportion of patients able to return to prior level of function grouped by patient ASA score; P value < .0001. Number of patients unable to regain baseline function in ASA 1–4, respectively: 1, 26, 261, and 97. Number of patients able to regain baseline function in ASA 1–4, respectively: 0, 9, 114, and 31. C, Proportion of patients readmitted to hospital system within 30 days of discharge grouped by patient ASA score; P value < .0001. Number of successful discharges in ASA 1–4, respectively: 1, 33, 308, and 96. Number of readmissions in ASA 1–4, respectively: 0, 4, 61, and 26. D, Proportion of patients dead and alive at discharge grouped by patient ASA score; P value < .0001. Number of deaths at discharge in ASA 1–4, respectively: 0, 0, 16, and 6. Number of patients alive at discharge in ASA 1–4, respectively: 1, 37, 373, and 122.

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  Fig. 3. Proportion of patients able to return to prior level of function grouped by preoperative functional status; P value = .0008. Previously independent patients unable to return to prior functionality, n = 234; able to regain functionality, n = 82. Previously partially dependent patients unable to return to prior functionality, n = 141; able to regain functionality, n = 42. Previously dependent patients unable to return to prior functionality, n = 10; able to regain functionality, n = 30.

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  Fig. 4. Proportion of patients dead and alive at discharge grouped by palliative care consult status; P value <.0001. Number of patients deceased (14) and alive (501) at time of discharge who did not receive a palliative care consult. Number of patients deceased (8) and alive (32) at time of discharge who did receive a palliative care consult.

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  Fig. 5. A, ACS rehabilitation prediction versus proportion of patients who actually required postoperative rehabilitation; P value <.0001. ACS rehabilitation score averaged for 331 patients for whom it could be calculated. A total of 343 of 540 patients required some element of postoperative rehabilitation. B, ACS mortality prediction and P-POSSUM mortality prediction versus actual patient mortality. ACS versus actual, P value < .0001; P-POSSUM versus actual, P value < .0001. ACS mortality score averaged for 331 patients for whom it could be calculated. P-POSSUM mortality score averaged for 421 patients for whom it could be calculated. Twenty-two of 555 patients died during their operative encounter.