Key result
Emergency surgery in patients over 85 shows similar mortality to younger cohorts but fewer home discharges.
Why the study?
The appropriateness and clinical significance of emergency surgery in elderly patients, especially those aged 85 years and older, remain challenging and unclear.
Does emergency surgery in patients aged ≥85 years result in different hospital mortality and discharge destinations compared to younger patients?
Observational (n=84)
No
Does emergency surgery in patients aged ≥85 years result in different hospital mortality and discharge destinations compared to younger patients?
Emergency surgery in patients aged ≥85 years has comparable hospital mortality to younger patients, but results in lower rates of direct discharge home due to reduced postoperative activities of daily living.
May inform perioperative counseling on functional risks in patients ≥85 years; hypothesis-generating for targeted recovery interventions.
Purpose The global population is aging rapidly, and physicians increasingly face challenges in determining the appropriateness of emergency surgery for elderly patients. This study aimed to evaluate the clinical significance of emergency operations in elderly patients. Methods This retrospective clinical study included patients transferred to the emergency department of Gunma University Hospital and admitted to the intensive care unit following emergency surgery between January 2013 and December 2019. Patients were categorized into three age groups: 18-64 years (Group Y), 65-84 years (Group M), and ≥85 years (Group E). Clinical courses, including activities of daily living (ADL), were compared across groups. The primary outcomes were hospital mortality and the proportion of patients discharged directly home; secondary outcomes included additional clinical characteristics. Results A total of 84 patients were included: 30 in Group Y, 42 in Group M, and 12 in Group E. Both preoperative and postoperative ADL scores were significantly lower in Group E. Medical costs did not differ significantly among the groups. Although hospital mortality was highest in Group E, the difference was not statistically significant. However, the proportion of patients discharged directly home was significantly lower in Group E. Conclusions Emergency operations in patients aged ≥85 years may achieve outcomes comparable to those in younger patients; however, the total treatment period is likely to be prolonged due to significantly reduced postoperative ADL.
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Oshima et al. (2025) conducted an observational in Emergency surgery requiring postoperative intensive care (n=84). Age ≥85 years vs. Age 18-84 years was evaluated on Hospital mortality and proportion of patients discharged directly home. Patients aged 85 years and older undergoing emergency surgery had similar hospital mortality to younger patients but experienced significantly lower rates of direct discharge home and greater declines in postoperative activities of daily living.
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