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
Comparative Study
. 2013 Sep;61(9):1608-14.
doi: 10.1111/jgs.12401. Epub 2013 Aug 8.

Advancing age and 30-day adverse outcomes after nonemergent general surgeries

Csaba Gajdos  1 , Deidre Kile, Mary T Hawn, Emily Finlayson, William G Henderson, Thomas N Robinson
Affiliations
Comparative Study

Advancing age and 30-day adverse outcomes after nonemergent general surgeries

Csaba Gajdos et al. J Am Geriatr Soc. 2013 Sep.

Abstract

Objectives: To determine whether 30-day postoperative mortality, complications, failure-to-rescue (FTR) rates, and postoperative length of stay increase with advancing age.

Design: Retrospective cohort study.

Setting: Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program.

Participants: Individuals undergoing nonemergent major general surgeries between 2005 and 2008 were studied (N = 165,600).

Measurements: Postoperative outcomes of interest were complications occurring within 30 days of the index operation, return to the operating room within 30 days, FTR after a postoperative complication, postsurgical length of stay, and 30-day mortality.

Results: Postoperative mortality, overall morbidity, and each type of postoperative complication increased with increasing age. Rates of FTR after each type of postoperative complication also increased with age. Mortality in individuals aged 80 and older after renal insufficiency (43.3%), stroke (36.5%), myocardial infarction (MI) (35.6%), and pulmonary complications (25-39%) were particularly high. Median postoperative length of stay increased with age after surgical site infection, urinary tract infection, pneumonia, return to the operating room, and overall morbidity but not after venous thromboembolism, stroke, MI, renal insufficiency, failure to wean from the ventilator, or reintubation.

Conclusion: Thirty-day mortality and complication and FTR rates increase with age after nonemergent general surgeries. Individuals aged 80 and older have especially high mortality after renal, cardiovascular, and pulmonary complications. Surgeons need to be more selective with advancing age regarding who will benefit from the surgical intervention.

Keywords: aging; postsurgical outcomes; surgery.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest:

No conflicts of interest or financial interest were declared by any of the authors.

References

    1. Geriatric Review Syllabus: A core curriculum in geriatric medicine. 6. New York NY: American Geriatric Society; 2006.
    1. Robinson TN, Eiseman B, Wallace JI, et al. Redefining geriatric preoperative assessment using frailty, disability and co-morbidity. Ann Surg. 2009;250:449–455. - PubMed
    1. Massarweh NN, Legner VJ, Symons RG, et al. Impact of advancing age on abdominal surgical outcomes. Arch Surg. 2009;144:1108–1114. - PubMed
    1. Al-Refaie WB, Parsons HM, Henderson WG, et al. Major Cancer surgery in the elderly. Ann Surg. 2010;251:311–318. - PubMed
    1. Al-Refaie WB, Parsons HM, Habermann EB, et al. Operative outcomes beyond 30-day mortality. Ann Surg. 2011;253:947–952. - PubMed

Publication types