News

Elderly Tolerate Elective, Major Bowel Surgery


 

SEATTLE — Patients over the age of 80 years generally have good outcomes after routine major bowel operations, but those who have emergency surgery fare less well, Dr. Demetrios J. Louis reported at the annual meeting of the American Society of Colon and Rectal Surgeons.

Dr. Louis reviewed 138 patients over the age of 80 years who underwent major intestinal operations at Rush University Medical Center, Chicago, between 1995 and 2005. Overall, 53% of the 138 patients had surgical complications and the mortality rate was 8%.

Average rates of complications, morbidity, and mortality were much higher in those who had the emergent procedures than in those who had elective procedures: The length of hospital stay was 2.7 times longer (21 days versus 8 days), the major complication rate was more than twice as high (81% versus 35%), and the mortality rate was more than 16 times higher (32% versus 2%). The patients who underwent emergency procedures tended to have significantly worse American Society of Anesthesiologists (ASA) status.

The findings suggest that “absolute age is not a determinant in outcome” and that success in older patients is determined primarily by ASA status and the need for emergency surgery, said Dr. Louis, of the department of general surgery at Rush University.

Commenting on Dr. Louis' presentation, Dr. James Ogilvie, a Minneapolis surgeon, said, “These are not necessarily unique findings if you look at other retrospective series in cardiac, hepatobiliary, and endocrine surgery.”

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