Surgical decision-making in octogenarians and nonagenarians remains challenging, requiring a balance between biologic age, severity of illness, and the potential for successful outcomes.
The phrase “oldest old” can be used to describe the egment of the population aged 80 years and older. The umber of elderly who reach this age group has increased reatly in recent years, posing new and difficult decisionaking challenges to general surgeons. With regard o surgical care of octogenarians and nonagenarians, ridelbaugh offered a thoughtful reflection in a 1988 merican College of Surgeons Bulletin, in which he wrote: We must constantly remind ourselves that just because procedure can be done doesn’t mean that it absolutely ust be done.” Today these issues still remain difficult: ow do we know when to proceed with invasive, alhough potentially successful, surgical care, and at what tage do we temper our resources and call for a “comfort easure only”? Traditional surgical approach has been to consider the atient’s “biologic age” rather than chronologic age and o offer surgical care based on severity of illness and omorbidities. In fact, the majority of routine surgical rocedures on the oldest-old patients are successful in art because of technologic advancements in surgical ntensive care units and the quality-improvement meaures on surgical nursing floors. Every surgeon rememers the occasional elderly patient who, after a prolonged CU course, returns to visit the care providers in, to their stonishment, remarkably good health. Such memories nly serve to reinforce surgeons’ beliefs that no matter ow bleak the postoperative course might be, hope for
K. Francis Lee (Fri,) conducted a editorial in Surgical care in octogenarians and nonagenarians. Surgical care was evaluated. Surgical decision-making in octogenarians and nonagenarians remains challenging, requiring a balance between biologic age, severity of illness, and the potential for successful outcomes.