Older patients (≥80 years) undergoing surgery had significantly higher 30-day mortality (2.3% vs 0.2%; P<0.001), rapid response calls, and unplanned ICU admissions than younger patients.
Observational (n=7,479)
No
Does older age (≥80 years) increase the risk of adverse post-operative outcomes in adult patients undergoing non-cardiac surgery?
Older patients (≥80 years) undergoing non-cardiac surgery are at significantly increased risk of adverse post-operative outcomes, including mortality, unplanned ICU admission, and rapid response calls.
Absolute Event Rate: 2.3% vs 0.2%
p-value: p=<0.001
BACKGROUND: Improved life-expectancies have seen increased rates of older patients undergoing surgery worldwide. These patients are at increased risk of post-operative complications. Australian evidence is limited regarding the association between age and post-operative outcomes, especially rapid response calls (RRCs) as indicators of adverse outcomes. The aim was to compare the post-operative outcomes of older patients (≥80 years) to younger patients. Specifically, 30-day in-hospital mortality; unplanned intensive care unit (ICU) admission; and RRC activation within 72 h post-operatively. METHODS: Single-centre retrospective observational study conducted over 12 months in a metropolitan Australian hospital. All adult patients (≥16 years) undergoing surgical procedures were included, excluding cardiac and obstetric/gynaecological surgeries. Patient co-morbidities were quantified using Charlson co-morbidity index (CCI) and American Society of Anesthesiologists physical status classification. RESULTS: Seven thousand four hundred and seventy-nine patients met inclusion criteria, 14.5% (n = 1086) aged ≥80 years. Most procedures (65%) were elective; and general surgical procedures were most common (24.2%). Compared to younger patients, older patients had significantly higher 30-day mortality (2.3% versus 0.2%; P < 0.001), increased post-operative RRC rates (7.3% versus 1.2%; P < 0.001), and unplanned ICU admissions (3.2% versus 1.6%; P < 0.001). Increasing age was associated with increased risk of post-operative RRC, unplanned ICU admission, and in-hospital mortality (all P < 0.01), with associations remaining significant after controlling for surgery type and CCI. CONCLUSION: Older patients are at increased risk of adverse post-operative outcomes, including post-operative RRC, unplanned ICU admission, and mortality, especially if they underwent emergency procedures. This has implications for preoperative risk stratification and post-operative management. Incidence of post-operative RRCs may be an important indicator of post-operative care.
Tang et al. (Tue,) conducted a observational in Surgical procedures (n=7,479). Older age (≥80 years) vs. Younger patients was evaluated on 30-day in-hospital mortality (p=<0.001). Older patients (≥80 years) undergoing surgery had significantly higher 30-day mortality (2.3% vs 0.2%; P<0.001), rapid response calls, and unplanned ICU admissions than younger patients.