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. 2022 Oct;46(10):2399-2408.
doi: 10.1007/s00268-022-06642-6. Epub 2022 Aug 4.

Outcomes After Major Surgical Procedures in Octogenarians: A Nationwide Cohort Study

Arthur K E Elfrink #  1   2 , Anna J Alberga #  3   4 , Mark I van Berge Henegouwen  5 , Wilhelmina H Scheurs  6 , Lydia G M van der Geest  7 , Hence J M Verhagen  4 , Jan-Willem T Dekker  8 , Dirk J Grünhagen  4 , Michel W J M Wouters #  3   9 , Joost M Klaase #  10 ; DICA Study Group
Collaborators, Affiliations

Outcomes After Major Surgical Procedures in Octogenarians: A Nationwide Cohort Study

Arthur K E Elfrink et al. World J Surg. 2022 Oct.

Abstract

Introduction: Aging of the worldwide population has been observed, and postoperative outcomes could be worse in elderly patients. This nationwide study assessed trends in number of surgical resections in octogenarians regarding various major surgical procedures and associated postoperative outcomes.

Methods: All patients who underwent surgery between 2014 and 2018 were included from Dutch nationwide quality registries regarding esophageal, stomach, pancreas, colorectal liver metastases, colorectal cancer, lung cancer and abdominal aortic aneurysms (AAA). For each quality registry, the number of patients who were 80 years or older (octogenarians) was calculated per year. Postoperative outcomes were length of stay (LOS), 30 day major morbidity and 30 day mortality between octogenarians and younger patients.

Results: No increase in absolute number and proportion of octogenarians that underwent surgery was observed. Median LOS was higher in octogenarians who underwent surgery for colorectal cancer, colorectal liver metastases, lung cancer, pancreatic disease and esophageal cancer. 30 day major morbidity was higher in octogenarians who underwent surgery for colon cancer, esophageal cancer and elective AAA-repair. 30 day mortality was higher in octogenarians who underwent surgery for colorectal cancer, lung cancer, stomach cancer, pancreatic disease, esophageal cancer and elective AAA-repair. Median LOS decreased between 2014 and 2018 in octogenarians who underwent surgery for stomach cancer and colorectal cancer. 30 day major morbidity decreased between 2014 and 2018 in octogenarians who underwent surgery for colon cancer. No trends were observed in octogenarians regarding 30 day mortality between 2014 and 2018.

Conclusion: No increase over time in absolute number and proportion of octogenarians that underwent major surgery was observed in the Netherlands. Postoperative outcomes were worse in octogenarians.

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Conflict of interest statement

None to be reported.

Figures

Fig. 1
Fig. 1
Trend in number of patients of 80 years or older who underwent surgery per quality registry compared to the total number of patients who underwent surgery per quality registry per year
Fig. 2
Fig. 2
Median length of stay with interquartile range per type of surgery stratified for patients who were younger than 80 years versus octogenarians
See this image and copyright information in PMC

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