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. 2024;92(4):469-474.
doi: 10.24875/CIRU.23000447.

Morbidity and mortality of emergency surgery in octogenarian patient

Dieter Morales-García  1 , José M Rabanal-Llevot  2 , Víctor García-Diez  3 , Pablo Colsa-Gutiérrez  4 , Alejandro Suárez-de la Rica  2 , Emilio Maseda-Garrido  5 , José M Lage-Sánchez  6 , Corrado P Marini  7 , Patrizio Petrone  8
Affiliations
Free article

Morbidity and mortality of emergency surgery in octogenarian patient

Dieter Morales-García et al. Cir Cir. 2024.
Free article

Abstract
in English, Spanish

Objective: To evaluate the health outcomes (postoperative morbidity and mortality) and the functional status at discharge of elderly patients older than 80 years who underwent emergency surgery.

Method: Patients > 80 years of age who underwent emergency surgery during one year at the Marqués de Valdecilla University Hospital, Santander, Spain. Preoperative data (age, sex, type of surgery, comorbidity) and postoperative data (complications) were evaluated, as well as in-hospital mortality, at 30 days and 6 months after surgery.

Results: Five-hundred-sixty-eight patients underwent emergency surgery between 2018 and 2019. After the review, 407 patients were included in the study. Average age: 86.9 years. Women 61.7%. Mean hospital stay: 10.4 days. Traumatic interventions 41.3%, vascular surgery 19.7%, general-digestive surgery 25.3%. Medium ASA risk: 2.88. Functional status at discharge: 3.15. Postoperative complications: Clavien-Dindo I 40.8%, II 40.3%, IIIA 3.4%, IIIB 2.5%, IVA 3.9%, IVB 2.0% and V 7.1%. Hospital mortality 7.1%, 30-day mortality 10.3%, mortality at 6 months 24.6%.

Conclusions: Patients > 80 years of age undergoing urgent surgery have high preoperative comorbidity, postoperative complications, and high mortality at 30 days and 6 months after surgery. This mortality is more significant in those ASA IV, nonagenarians and those undergoing high-risk surgery.

Objetivo: Evaluar los resultados en salud (morbilidad y mortalidad posoperatorias) y el estado funcional al alta de los pacientes mayores de 80 años sometidos a cirugía de urgencia.

Método: Pacientes de edad > 80 años sometidos a cirugía de urgencia durante 1 año en el Hospital Universitario Marqués de Valdecilla, Santander, España. Se evaluaron datos preoperatorios (edad, sexo, tipo de cirugía, comorbilidad) y posoperatorios (complicaciones), así como mortalidad hospitalaria, a los 30 días y a los 6 meses de la cirugía.

Resultados: En 2018-2019 fueron operados de urgencia 568 pacientes, de los cuales 407 fueron incluidos en el estudio. Edad media: 86.9 años. El 61.7% fueron mujeres. Estancia media hospitalaria: 10.4 días. El 41.3% fueron intervenciones traumatológicas, el 19.7% cirugía vascular, el 25.3% cirugía general-digestiva. Riesgo ASA medio: 2.88. Estado funcional al alta: 3.15. Complicaciones posoperatorias: Clavien-Dindo I 40.8%, II 40.3%, IIIA 3.4%, IIIB 2.5%, IVA 3.9%, IVB 2.0% y V 7.1%. Mortalidad: hospitalaria 7.1%, a los 30 días 10.3% y a los 6 meses 24.6%.

Conclusiones: Los pacientes > 80 años sometidos a cirugía urgente presentan elevada comorbilidad preoperatoria, complicaciones posoperatorias y elevada mortalidad a 30 días y 6 meses de la cirugía. Esta mortalidad es más significativa en los ASA IV, nonagenarios y sometidos a cirugía de alto riesgo.

Keywords: Cirugía de urgencia; Elderly patient; Emergency surgery; Morbidity; Morbilidad; Mortalidad; Mortality; Octogenarian; Octogenario; Paciente anciano.

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