Department of Health Management, Faculty of Health Sciences, Sabahattin Zaim University, İstanbul, Turkey
Department of Nursing, Institute of Graduate Studies, Bahçeşehir University, İstanbul, Turkey
Turk J Med Sci. 2021 Feb 26;51(1):61-67. doi: 10.3906/sag-2001-27.
BACKGROUND/AIM: With the increase in the elderly population, the elderly proportion needing emergency surgery is also increasing. Despite medical advances in surgery and anesthesia, negative postoperative outcomes and high mortality rates are still present in elderly patients undergoing emergency surgery. Comorbidities are described as the main determining factors in poor outcomes. In this metaanalysis, it was aimed to investigate the effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery.
The studies published between 2010-2019 were scanned from databases of Google Scholar, Cinahl, Pub Med, Medline and Web of Science. Quality criteria proposed by Polit and Beck were used in the evaluation of the included studies. Interrater agreement was calculated by using the Kappa statistic, effect size by using the odds ratio, and heterogeneity among studies by using the Cochran’s Q statistics. Kendall’s Tau-b coefficient and funnel plot were used to determine publication bias.
A total of 9 studies were included in the research. There was a total of 1330 cases in the studies. The total mortality rate was 21% (n = 279), the total rate of having a comorbid factor was 83.6% (n = 1112), and the rate of having a comorbid factor in mortality was 89.2% (n = 249). According to the fixed effects model, the total effect size of comorbid factors on causing mortality was not statistically significant with a value of 1.296 (C.I; 0.84-1.97; P > 0.05).
Our study revealed that comorbidity had no significant effect on causing mortality in geriatric patients undergoing emergency abdominal surgery. There are controversial results in the literature, and in order to reach more precise results, studies involving wider groups of patients and further studies examining the specific effect of certain comorbid conditions are needed.
背景/目的：随着老年人口的增加，需要紧急手术的老年人比例也在增加。尽管手术和麻醉方面取得了医学进步，但接受紧急手术的老年患者仍存在术后不良结局和高死亡率。合并症被描述为不良结局的主要决定因素。在这项荟萃分析中，旨在研究合并症对接受紧急腹部手术的老年患者死亡率的影响。
从 Google Scholar、Cinahl、Pub Med、Medline 和 Web of Science 数据库中扫描了 2010-2019 年期间发表的研究。使用 Polit 和 Beck 提出的质量标准对纳入的研究进行评估。使用 Kappa 统计量计算组间一致性，使用优势比计算效应大小，使用 Cochran's Q 统计量衡量研究间的异质性。使用 Kendall's Tau-b 系数和漏斗图确定发表偏倚。
共有 9 项研究纳入研究。研究共有 1330 例病例。总死亡率为 21%（n=279），合并症因素总发生率为 83.6%（n=1112），死亡率合并症因素发生率为 89.2%（n=249）。根据固定效应模型，合并症因素对导致死亡率的总效应大小无统计学意义，其值为 1.296（C.I；0.84-1.97；P>0.05）。
我们的研究表明，合并症对接受紧急腹部手术的老年患者的死亡率没有显著影响。文献中有争议的结果，为了得出更精确的结果，需要涉及更广泛患者群体的研究，并进一步研究某些合并症的具体影响。
