The outcome of elderly patients after operation for acute abdomen

Abstract

A retrospective analysis of 224 patients was carried out to evaluate the outcome of elderly patients after operation for acute abdominal pain. The mean (+/- SD) age of the patients was 74.6 (+/- 6.4) years (range 65-96) and the male/female ratio was 104/120. The most common causes for an emergency operation were acute biliary disease (26%), acute appendicitis (18%), gastrointestinal cancer (11%) and incarcerated hernia (10%). Twenty-nine patients (13%) died during the one-month postoperative period. The most common causes of death were gastrointestinal cancer (24%), ischaemic heart disease (14%) and complicated peptic ulcer disease (14%). Ninety-two (41%) patients had non-lethal postoperative complications, the commonest of which were wound infection or dehiscence (28%), urinary tract infection (17%), and paralytic ileus (8%). Ten patients were reoperated on for postoperative complications. The mean hospitalization time was 12.5 days (range 1-99). The results in the analysis of the long-term outcome (mean follow-up time 21 months) revealed that 17% of the primarily survived patients had died. Living patients were satisfied with the treatment and only a few patients were institutionalised after surgery. We conclude that both the short-term and long-term outcome of elderly patients after an emergency abdominal operation is good in benign diseases, and active surgery is justified.