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Elective Surgery Trends and Outcomes of Nonagenarians and Centenarians in Otolaryngology-Head and Neck Surgery: A NSQIP Study.
Srinivasan, Yashes; Briano, Juan; Czaja, Sara; Lachs, Mark S; Rosen, Anthony E; Stewart, Michael G; Rameau, Anaïs.
Affiliation
  • Srinivasan Y; Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A.
  • Briano J; Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A.
  • Czaja S; Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, U.S.A.
  • Lachs MS; Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, U.S.A.
  • Rosen AE; Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, U.S.A.
  • Stewart MG; Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A.
  • Rameau A; Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A.
Laryngoscope ; 134(9): 3989-3996, 2024 Sep.
Article de En | MEDLINE | ID: mdl-38587164
ABSTRACT

OBJECTIVE:

To describe types and outcomes of elective otolaryngological surgeries undergone by patients ≥90 years of age and to assess whether very old age is an independent risk factor for postsurgical complications and death.

METHODS:

The National Surgical Quality Improvement Program, a validated national prospective surgical outcomes database, was used to identify all patients aged 65 years and older who underwent elective otolaryngological procedures from 2011 to 2020. Study outcomes included minor complications, major life-threatening complications, and 30-day mortality. Predictors of outcomes, including frailty, were identified using univariable analyses and age was added into the final logistic regression models with stepwise selection.

RESULTS:

A total of 40,723 patients met inclusion criteria; 629 (1.5%) patients were ≥90 years of age. Of the 63,389 procedures, head and neck (67.6%) and facial plastics and reconstructive (15.0%) procedures were most common. The overall incidence of major life-threatening complications, minor complications, and death was 2.0%, 3.5%, and 0.4%, respectively. Age ≥90 was significantly associated with an increased risk for 30-day mortality, but not with major or minor postoperative complications. A high modified frailty index was significantly associated with an increased risk for major postoperative complications and death amongst patients ≥90 years.

CONCLUSIONS:

Elective otolaryngological surgery can be safe in relatively healthy nonagenarians and centenarians, though there is a small increased risk of 30-day mortality. Although older age can predispose patients to other comorbidities, age alone should not deter surgeons and patients from considering elective otolaryngological procedures. Frailty may be a better predictor for surgical outcomes. LEVEL OF EVIDENCE IV Laryngoscope, 1343989-3996, 2024.
Sujet(s)
Mots clés

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Complications postopératoires / Procédures de chirurgie oto-rhino-laryngologique / Interventions chirurgicales non urgentes Limites: Aged / Aged80 / Female / Humans / Male Pays/Région comme sujet: America do norte Langue: En Journal: Laryngoscope Sujet du journal: OTORRINOLARINGOLOGIA Année: 2024 Type de document: Article Pays d'affiliation: États-Unis d'Amérique Pays de publication: États-Unis d'Amérique

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Complications postopératoires / Procédures de chirurgie oto-rhino-laryngologique / Interventions chirurgicales non urgentes Limites: Aged / Aged80 / Female / Humans / Male Pays/Région comme sujet: America do norte Langue: En Journal: Laryngoscope Sujet du journal: OTORRINOLARINGOLOGIA Année: 2024 Type de document: Article Pays d'affiliation: États-Unis d'Amérique Pays de publication: États-Unis d'Amérique