Operative Risk Factors of Colon Resection in the Elderly

Between January 1, 1974, and December 31, 1978, patients over 50 years of age underwent colon resections in three West Virginia Hospitals. The patients were studied by decades of age to compare the operative risks in younger and elderly patients. Preoperative assessments of cardiovascular, pulmonary, renal, hepatic, metabolic and nutritional states were compared with the postoperative morbidity and mortality rates. Complications occurred in 33% of all the patients who had resections, with 17 (4.8%) deaths. Mortality rates compared by decades of age correlated with the number of pre-existing conditions, and not with age as an isolated factor. There were no deaths in patients with no pre-existing conditions. The rate of infectious complications increased because the number of emergency procedures increased. This was also true for the mortality rate. Preoperative pulmonary and nutritional problems were significant contributing factors in the patients who died from sepsis. Careful preoperative assessment, correction of pre-existing pulmonary and nutritional deficiencies, and avoidance of emergency procedures may improve the morbidity and mortality rates associated with colon resections in elderly patients.