Department of Anesthesiology, The Bruce Rappaport Faculty of Medicine, Rambam Health Care Campus, Technion-Israel Institute of Technology, 31096, Haifa, Israel.
Aging Clin Exp Res. 2013 Apr;25(1):75-9. doi: 10.1007/s40520-013-0011-3. Epub 2013 Apr 3.
This study was designed to find predictors for adverse post-operative outcomes in elderly patients aged 80 years and older, who underwent urologic surgery.
In this prospective observational study, we analysed data, including age, gender, American Society of Anesthesiologists (ASA) class, co-morbidities, number of regular medications, type and extent of surgery, type of anesthesia, duration of surgery and hospitalization, post-operative morbidity and mortality. We studied the correlations between each pre- and intra-operative parameter to the consequence, to find predictors for adverse outcome.
During a 12-month period, 217 patients underwent 294 urologic procedures in our institution. Ninety-eight procedures (33%) were followed by complications and 11 patients (5%) died. Patients who had uneventful surgery and hospitalization were significantly younger than those who experienced morbidity or mortality. There was a significantly higher complication rate among patients with a higher ASA class or with ischemic heart disease, following higher graded or longer operations, and after emergency surgery.
Older age is a significant risk factor. Patients with higher ASA class or ischemic heart disease are at higher risk for post-operative complications and thus, require careful follow-up. In this age population, extensive or prolonged surgery should be carefully considered.
本研究旨在发现 80 岁及以上接受泌尿科手术的老年患者术后不良结局的预测因素。
在这项前瞻性观察研究中，我们分析了包括年龄、性别、美国麻醉医师协会（ASA）分级、合并症、常规用药数量、手术类型和范围、麻醉类型、手术和住院时间、术后发病率和死亡率在内的数据。我们研究了每个术前和术中参数与结果之间的相关性，以寻找不良结局的预测因素。
在 12 个月的时间里，我们机构的 217 名患者接受了 294 例泌尿科手术。98 例（33%）手术和住院期间出现并发症，11 名患者（5%）死亡。手术和住院期间无并发症的患者明显比出现发病率或死亡率的患者年轻。ASA 分级较高或有缺血性心脏病、手术分级较高或时间较长、急诊手术的患者并发症发生率显著较高。
年龄较大是一个显著的风险因素。ASA 分级较高或有缺血性心脏病的患者术后并发症风险较高，因此需要密切随访。在这个年龄段，广泛或延长的手术应谨慎考虑。
