Fiszer Patryk, Pogorzelski Ryszard, Toutounchi Sadegh, Szostek Małgorzata M, Krajewska Ewa, Jakuczun Wawrzyniec, Tworus Robert, Skórski Maciej
Department of General and Thoracic Surgery, Warsaw Medical University.
Pol Przegl Chir. 2012 Apr;84(4):173-6. doi: 10.2478/v10035-012-0028-x.
The aim of the study was to evaluate the results of general surgical treatment of patients over 80 years of age.
Three hundred and four patients aged 80 to 105 years with general surgical disorders, treated in 2005-2009, were retrospectively included in the study. The collected information included demographic data, coexisting diseases, the mode of admission, the diagnosis, the method and result of treatment, and also potential complications and 30-day mortality. The data were subjected to statistical analysis.
The study group included 186 women and 118 men. Two hundred patients (65.8%) were admitted in an emergency setting. The most common causes of immediate hospitalisation were: mechanical ileus (26.5%), gastrointestinal bleeding (22%), trauma (16%), and gall-bladder disorders (8.5%). The remaining 104 (34.2%) patients were operated upon on an elective basis. An emergency operation was required by 121 (60%) of the patients admitted in an emergency setting; the remaining ones were treated conservatively. Hernia plasties (27.5%), cholecystectomies (15.3%), colorectal resections (13.2%), strumectomies (11.2%) and endoscopies (6.1%) predominated among elective surgeries.The total number of complications and mortality were 19.4% and 14.5%, respectively. The number of complications and mortality were significantly higher in the group of patients admitted in an emergency setting (25.5% and 20.5%, respectively) than in patients admitted on an elective basis (8.7% and 2.9%, respectively), p<0.01.The mean duration of hospitalisation was 9.7 days (1 to 60 days), with a small difference between the groups of patients treated on an elective and emergency basis (8.5 and 10.4 days), p=0.181.
The results of surgical treatment of elderly patients do not significantly differ from the results of treatment of the general population. Much worse results, coupled with a significant increase in mortality, are observed in patients admitted and treated on an emergency basis.
本研究的目的是评估80岁以上患者的普通外科治疗结果。
回顾性纳入2005年至2009年期间治疗的304例年龄在80至105岁之间患有普通外科疾病的患者。收集的信息包括人口统计学数据、并存疾病、入院方式、诊断、治疗方法和结果,以及潜在并发症和30天死亡率。对数据进行统计分析。
研究组包括186名女性和118名男性。200例(65.8%)患者为急诊入院。急诊入院的最常见原因是:机械性肠梗阻(26.5%)、胃肠道出血(22%)、创伤(16%)和胆囊疾病(8.5%)。其余104例(34.2%)患者为择期手术。择期手术中以疝修补术(27.5%)、胆囊切除术(15.3%)、结直肠切除术(13.2%)、甲状腺切除术(11.2%)和内镜检查(6.1%)为主。并发症总数和死亡率分别为19.4%和14.5%。急诊入院患者组的并发症数和死亡率(分别为25.5%和20.5%)显著高于择期入院患者组(分别为8.7%和2.9%),p<0.01。平均住院时间为9.7天(1至60天),择期治疗和急诊治疗的患者组之间差异较小(8.5天和10.4天),p=0.181。
老年患者的手术治疗结果与普通人群的治疗结果无显著差异。急诊入院并接受治疗的患者结果要差得多,且死亡率显著增加。