Key result
Elderly gastric surgery carries ~29% early mortality, linked to emergency status and high ASA scores.
Why the study?
The intra-hospital mortality rate and risk factors in elderly patients undergoing gastric surgical procedures were not well defined.
Observational (n=108)
No
Intra-hospital mortality in elderly patients undergoing gastric surgery is high (28.7%) and strongly associated with emergency presentation, high ASA scores, and pre-existing comorbidities.
Elevated mortality risk in elderly gastric surgery patients warrants preoperative risk stratification; leaves open whether targeted interventions improve outcomes.
The use of screening programms in elderly population (age ≥65 years) comprises an increasing proportion of patients undergoing emergency general surgery (EGS) procedures nowadays. The aim was to determine the intra-hospital mortality rate in elderly patients undergoing gastric surgical procedures. 108 elderly patients (≥65 years old) were examined, divided into two groups: deceased and surviving surgical patients, treated for diseases (benign and malignant) of the stomach. The patients were divided into four age groups and five ASA groups, taking into account the presence of chronic diseases, the values of some laboratory parameters, administered transfusion and the occurrence of surgical complications during hospitalization. The mortality rate among elderly patients was 28.7%. The significant risk factors for mortality were: emergency surgery (p < 0.001), bleeding gastric ulcer operations (p = 0.042), lung (p = 0.003), kidney (p < 0.001), heart (p = 0.025) diseases, ASA score of 4 or higher (p < 0.001), serum levels (higher after two times measurement) of creatinine, haemoglobin, CRP, PCT and glycemia (p < 0.001). In order to improve medical treatment, the determination of independent validated risk indicators for mortality in elderly patients might lead to developing a dedicated scoring system.
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Pešić et al. (2019) conducted an observational in Gastric surgical diseases (n=108). Emergency surgery and clinical risk factors vs. Elective surgery and absence of risk factors was evaluated on Early postoperative mortality. The early postoperative mortality rate in elderly patients undergoing gastric surgery was 28.7%, with emergency surgery, ASA score ≥4, and specific comorbidities significantly increasing the risk of death.
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