Key result
Surgery in patients ≥85 years is linked to an ~86% higher complication rate versus younger patients.
Why the study?
The increasing prevalence of chronic diseases and neoplasms in patients aged 85 or more necessitates assessment of surgical treatment risks and outcomes in this population, especially for colorectal cancer.
Does surgical treatment in patients aged 85+ carry a higher risk of complications and mortality compared to younger patients?
Observational (n=185)
Does surgical treatment in patients aged 85+ carry a higher risk of complications and mortality compared to younger patients?
Absolute Event Rate: 34.8% vs 18.7%
p-value: p=< 0.01
Emergency surgical treatment in patients aged 85+ is associated with significantly higher risks of complications and mortality compared to younger patients, whereas elective surgery shows similar early outcomes.
Emergency surgery in ≥85-year-olds carries higher complication and mortality risk; retrospective data leave open whether optimized elective pathways improve outcomes.
UNLABELLED: The increase in prevalence of chronic diseases in old age is concomitant with increasing risk of neoplasms requiring surgical treatment. The aim of the study was to assess the indications, treatment outcomes, complications and mortality associated with surgical treatment of patients aged 85 or more, with special consideration of colorectal cancer. MATERIAL AND METHODS: The retrospective analysis involved a group of 94 patents (x = 88.9) aged 85 or more and treated surgically in the years 2006-2011. The results were compared with a randomly selected control group of 91 patients aged 45-75 (x = 56,4) and treated surgically in the same period. RESULTS: Neoplastic diseases in the study group (85 ≥), compared with the control group (< 75), were a significantly more frequent indication for surgical treatment (p < 0.01). In the group of patients aged 85 or more, the most frequent indications for elective surgery were neoplasms of the skin and subcutaneous tissue (26.4%) and gastrointestinal neoplasms, mainly colorectal cancer (23.5%). Postoperative complications were significantly more frequent (p < 0.01) among patients aged 85 or more (n = 27; 34.8%) than in the younger group (n = 17; 18.7%). Postoperative mortality among patients undergoing emergency surgery was significantly higher (p < 0.05) in the senior group than in the group of younger patients. CONCLUSIONS: Surgical procedures in patients aged 85 or more are most frequently performed in the emergency setting, and their most common cause are neoplastic diseases. Emergency surgical treatment in patients aged 85 or more is associated with a significantly higher risk, compared with younger age groups, of developing multi-organ postoperative complications, usually leading to death. Elective surgical treatment in patients aged 85+ after appropriate preoperative preparation and in the group of younger patients shows similar early outcomes.
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Stępień et al. (2014) conducted an observational in Surgical treatment (n=185). Age ≥85 years vs. Age 45-75 years was evaluated on Postoperative complications (p=< 0.01). Surgical treatment in patients aged ≥85 years was associated with a significantly higher rate of postoperative complications compared to patients aged 45-75 years (34.8% vs 18.7%; p<0.01).
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