Gogna Shekhar, Gachabayov Mahir, Latifi Rifat
Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Acta Chir Belg. 2025 Apr 28:1-7. doi: 10.1080/00015458.2021.1920669.
About five billion people worldwide lack access to safe surgery and multispecialty surgical volunteerism missions (SVMs) offer a plausible solution to this problem. This study aimed to evaluate the outcomes of elderly patients operated on over 13 surgical missions between 2006 and 2019 from 'Operation Giving Back Bohol' (OGBB) Tagbilaran, Philippines.
This was a retrospective analysis of prospectively collected data on all patients treated during SVM over 13 years (2006-2019). Non-elderly (age 16-64 years) were compared with the elderly (age ≥ 65 years) for pre-, intra-, and postoperative variables. Multivariable logistic regression was utilized to identify independent predictors of postoperative complications.
Of 1184 patients, the majority (1030) was in the non-elderly group and 154 in the elderly. The mean age was 36 ± 13.6 and 68.3 ± 3.8 years in the non-elderly and elderly groups, respectively. Comorbidities, type of surgery, type of anesthesia, operating time, estimated blood loss, estimated blood loss, need for blood transfusion, postoperative complication rates, comprehensive complication index, length of hospital, ICU requirement, and mortality rates stay did not significantly differ between the groups. Multivariable logistic regression found pelvic surgery (OR (95%CI)=3.7 (1.3-10.8); =.01), hypertension (OR (95%CI)=8.4 (2.2-32.9); <.01), and intraoperative blood loss (OR (95%CI) = 1.007 (1.005-1.009); <.01) to be independent predictors of postoperative complications.
Elderly patients may safely undergo general surgery procedures in surgical volunteer missions, and age alone should not preclude them.
全球约有50亿人无法获得安全的外科手术，多专科外科志愿服务团（SVMs）为解决这一问题提供了一个可行的方案。本研究旨在评估2006年至2019年间在菲律宾塔比拉兰市“回馈薄荷岛行动”（OGBB）的13次外科手术任务中接受手术的老年患者的手术结果。
这是一项对13年（2006 - 2019年）期间在SVM中接受治疗的所有患者的前瞻性收集数据的回顾性分析。将非老年患者（年龄16 - 64岁）与老年患者（年龄≥65岁）在术前、术中和术后变量方面进行比较。采用多变量逻辑回归来确定术后并发症的独立预测因素。
在1184例患者中，大多数（1030例）属于非老年组，154例属于老年组。非老年组和老年组的平均年龄分别为36±13.6岁和68.3±3.8岁。两组在合并症、手术类型、麻醉类型、手术时间、估计失血量、输血需求、术后并发症发生率、综合并发症指数、住院时间、重症监护病房需求和死亡率方面无显著差异。多变量逻辑回归发现盆腔手术（比值比（95%置信区间）=3.7（1.3 - 10.8）；P =.01）、高血压（比值比（95%置信区间）=8.4（2.2 - 32.9）；P <.01）和术中失血量（比值比（95%置信区间） = 1.007（1.005 - 1.009）；P <.01）是术后并发症的独立预测因素。
老年患者在外科志愿服务任务中可安全地接受普通外科手术，不应仅凭年龄就将他们排除在外。
