Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Apr;63(2):151-6.
doi: 10.1590/s1807-59322008000200001.

Prognostic factors for mortality among patients above the 6th decade undergoing non-cardiac surgery: cares--clinical assessment and research in elderly surgical patients

Adriana Nunes Machado  1 , Maria do Carmo Sitta, Wilson Jacob Filho, Luíz Eugênio Garcez-Leme
Affiliations

Prognostic factors for mortality among patients above the 6th decade undergoing non-cardiac surgery: cares--clinical assessment and research in elderly surgical patients

Adriana Nunes Machado et al. Clinics (Sao Paulo). 2008 Apr.

Abstract

Purpose: To ascertain perioperative morbimortality and identify prognostic factors for mortality among patients > or = 55 years who undergo non-cardiac surgery.

Methods: A retrospective cohort of 403 patients relating to perioperative morbidity-mortality. Data were collected from a standardized protocol on gender, age, comorbidities, medications used, smoking, alcohol abuse, chronic use of benzodiazepine, nutritional status, presence of anemia, activities of daily living, American Society of Anesthesiology classification, Detsky's modified cardiac risk index--American College of Physicians, renal function evaluation, pulmonary risk according to the Torrington scale, risk of thromboembolic events, presence of malignant disease and complementary examinations.

Results: The mean age of the subjects was 70.8 +/- 8.1 years. The "very old" (> or =80 years) represented 14%. The mortality rate was 8.2%, and the complication rate was 15.8%. Multiple logistic regression showed that a history of coronary heart disease (OR: 3.75; p=0.02) and/or valvular heart disease (OR: 31.79; p=0.006) were predictors of mortality. The American Society of Anesthesiology classification was shown to be the best scale to mark risk (OR: 3.01; p=0.016). Nutritional status was a protective factor, in which serum albumin increases of 1 mg/dl decreased risk by 63%.

Discussion: The results indicate that serum albumin, coronary heart disease, valvular heart disease and the American Society of Anesthesiology classification could be prognostic predictors for aged patients in a perioperative setting. In this sample, provided that pulmonary, cardiac and thromboembolic risks were properly controlled, they did not constitute risk factors for mortality. Furthermore, continuous effort to learn more about the preoperative assessment of elderly patients could yield intervention possibilities and minimize morbimortality.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Odds of death related to the prognostic factors on perioperative period
See this image and copyright information in PMC

References

    1. McGoldrick KE. The Graying of America: Anesthetic Implications for Geriatric Outpatients. ASA Refresher Courses in Anesthesiology. 2002;33:165–74.
    1. Leung JM, Liu LL. Current Controversies in the Perioperative Management of Geriatric Patients. ASA Refresher Courses in Anesthesiology. 2001;29:175–87.
    1. Muravchick S. Physiological Changes of Aging. ASA Refresher Courses in Anesthesiology. 2003;31:139–49.
    1. Sitta MC, Machado AN, Lapa MS. Avaliação perioperatória. In: Jacob Filho W, Amaral JRG, editors. Avaliação Global do Idoso – Manual da Liga do Gamia. 1. São Paulo: Editora Atheneu; 2005. pp. 193–214.
    1. Dibert C. Delirium and the older adult after surgery. Perspectives. 2004;28:10–6. - PubMed