Wong Evan G, Trelles Miguel, Dominguez Lynette, Mupenda Mwania Jerome, Kasonga Tshibangu Cheride, Haq Saqeb Sanaul, Hazrati Khalil U R, Gupta Shailvi, Burnham Gilbert, Kushner Adam L
Centre for Global Surgery, McGill University Health Centre, 1650 Cedar Avenue, L9 411, Montreal, QC, H3G 1A4, Canada,
World J Surg. 2015 Mar;39(3):652-7. doi: 10.1007/s00268-014-2855-x.
As the demographic transition occurs across developing countries, an increasing number of elderly individuals are affected by disasters and conflicts. This study aimed to evaluate the elderly population that underwent an operative procedure at MSF facilities.
A retrospective review of prospectively collected operative cases performed at MSF-Operational Centre Brussels (MSF-OCB) facilities between June 2008 and December 2012 was completed. Baseline demographic data, American Society of Anesthesiologists (ASA) physical status and surgical indications were collected for each patient. For each procedure, the degree of urgency, anesthesia type, and intra-operative mortality were noted. All patients aged 50 and over at the time of the procedure were considered elderly, as proposed by the World Health Organization (WHO). Comparisons were made with the 18-49 age group in order to elucidate differences between older and younger individuals.
We reviewed a total of 93,385 procedures performed on 83,911 patients in 21 different countries. Patients aged 50 and over comprised 11.5% (9,628/83,911) of all patients. While most procedures (57.6%) in the comparison group were urgent, this proportion decreased substantially in the elderly. Intra-operative mortality was considerably lower in the 50-59 group (0.12%) but increased with each age stratum. The most commonly performed surgical procedures in the elderly included herniorrhaphies, simple and extensive wound debridements, abscess incision and drainages, minor tumorectomies, and urological procedures.
In light of the increasing elderly population in developing countries, efforts should be made to better quantify and address their surgical needs.
随着发展中国家人口结构的转变，越来越多的老年人受到灾害和冲突的影响。本研究旨在评估在无国界医生组织设施接受手术治疗的老年人群。
对2008年6月至2012年12月在无国界医生组织布鲁塞尔手术中心（MSF-OCB）设施进行的前瞻性收集的手术病例进行回顾性研究。收集每位患者的基线人口统计学数据、美国麻醉医师协会（ASA）身体状况和手术指征。对于每台手术，记录其紧急程度、麻醉类型和术中死亡率。按照世界卫生组织（WHO）的提议，所有手术时年龄在50岁及以上的患者被视为老年人。与18-49岁年龄组进行比较，以阐明老年人与年轻人之间的差异。
我们回顾了在21个不同国家对83,911名患者进行的总共93,385台手术。50岁及以上的患者占所有患者的11.5%（9,628/83,911）。虽然比较组中的大多数手术（57.6%）是紧急手术，但这一比例在老年人中大幅下降。50-59岁组的术中死亡率相当低（0.12%），但随着每个年龄层的增加而上升。老年人中最常进行的外科手术包括疝修补术、简单和广泛的伤口清创术、脓肿切开引流术、小型肿瘤切除术和泌尿外科手术。
鉴于发展中国家老年人口不断增加，应努力更好地量化并满足他们的手术需求。
