Outcomes of emergency abdominal surgery in octogenarians: A single-center analysis.
Am J Surg
; 218(2): 248-254, 2019 08.
Article
en En
| MEDLINE
| ID: mdl-30509459
ABSTRACT
BACKGROUND:
The aim of this study was to assess outcomes of octogenarians undergoing emergency abdominal surgery (EAS).METHODS:
Octogenarians undergoing EAS 12/2011-12/2016 were retrospectively analysed. The outcomes were assessed by univariable and multivariable regression analysis.RESULTS:
One-hundred-forty patients with a median age of 83.9 years were included. EAS was performed for cholecystitis (27.1%), ileus (22.1%), hollow viscus perforation (16.4%), diverticulitis (12.9%), mesenteric ischemia (10.0%), incarcerated hernia (9.3%), and appendicitis (2.1%). The overall and early (within 7 days from surgery) mortality rate was 16.4% and 10.0%, respectively. Multivariable analysis revealed age (OR 1.24,CI95% 1.04-1.47,pâ¯=â¯0.015), ASA scores≥4 (OR 11.15,CI95% 2.39-52.02,pâ¯=â¯0.002), mesenteric ischemia (OR 52.60,CI95% 8.93-309.94,pâ¯<â¯0.001) and ICU admission (OR 9.23,CI95% 1.74-49.04,pâ¯=â¯0.009) as independent predictors for mortality. Postoperative withdrawal of care accounted for 36% of early mortalities.CONCLUSIONS:
One third of early mortality in octogenarians was due to postoperative withdrawal of care. An interdisciplinary decision-making including patients' and relatives' wishes may avoid ethically questionable interventions in octogenarians.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Procedimientos Quirúrgicos Operativos
/
Tratamiento de Urgencia
/
Abdomen
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Am J Surg
Año:
2019
Tipo del documento:
Article
País de afiliación:
Suiza