There is a higher risk of complications and death after commonly performed abdominal surgical procedures among older adults, according to a new study.
Nader N. Massarweh, and colleagues at University of Washington School of Medicine, Seattle, examined complication and death rates of 101,318 adults age 65 or older who underwent common abdominal procedures such as cholecystectomy (gall bladder removal), hysterectomy and colectomy from 1987 to 2004.
AdvertisementComplications were recorded within 90 days of discharge and deaths were recorded within 90 days of hospital admission.
The 90-day complication rate was 17.3 percent and the 90-day death rate was 5.4 percent.
"Advancing age was associated with increasing frequency of complications (65 to 69 years, 14.6 percent; 70 to 74 years, 16.1 percent; 75 to 79 years, 18.8 percent; 80 to 84 years, 19.9 percent; 85 to 89 years, 22.6 percent; and 90 years or older, 22.7 percent) and mortality (65 to 69 years, 2.5 percent; 70 to 74 years, 3.8 percent; 75 to 79 years, 6 percent; 80 to 84 years, 8.1 percent; 85 to 89 years, 12.6 percent; and 90 years or older, 16.7 percent)," the authors said.
"After adjusting for demographic, patient and surgical characteristics as well as hospital volume, the odds of early postoperative death increased considerably with each advance in age category. These associations were found among patients with both cancer and non-cancer diagnoses and for both elective and non-elective admissions.
"Older adults may be less able to adapt to the stress of surgery or to the added stress of any postoperative complication, greatly increasing their risk of early mortality.
"These effects appear to be additive, highlighting the need for interventions to both prevent decline among older patients and avoid postsurgical complications," they added.
The study has been published in the December issue of Archives of Surgery, one of the JAMA/Archives journals.