RT Journal
A1 Massarweh NN, Legner VJ, Symons RG, McCormick WC, Flum DR
T1 IMpact of advancing age on abdominal surgical outcomes
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD December 21
VO 144
IS 12
SP 1108
OP 1114
DO 10.1001/archsurg.2009.204
UL http://dx.doi.org/10.1001/archsurg.2009.204
AB Objective 
    To describe the population-level risk of adverse outcomes among older adults undergoing common abdominal surgical procedures.Design 
    Retrospective, population-based cohort study.Setting 
    Washington State hospital discharge database.Participants 
    A total of 101 318 adults 65 years or older who underwent common abdominal procedures such as cholecystectomy, colectomy, and hysterectomy from 1987 through 2004.Main Outcome Measures 
    Ninety-day rates of postsurgical morbidity and mortality.Results 
    The 90-day cumulative incidence of complications was 17.3%, with a 90-day mortality rate of 5.4%. Advancing age was associated with increasing frequency of complications (65-69 years, 14.6%; 70-74 years, 16.1%; 75-79 years, 18.8%; 80-84 years, 19.9%; 85-89 years, 22.6%; and ≥90 years, 22.7%; trend test, P < .001) and mortality (65-69 years, 2.5%; 70-74 years, 3.8%; 75-79 years, 6.0%; 80-84 years, 8.1%; 85-89 years, 12.6%; and ≥90 years, 16.7%; trend test, P < .001). 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 noncancer diagnoses and for both elective and nonelective admissions (trend test, P < .001).Conclusions 
    Among older adults, the risk of complications and early death after commonly performed abdominal procedures is greater than previously reported. These rates should be considered in ongoing quality improvement initiatives and may be helpful when counseling patients regarding abdominal operations.