Park Jong Soeb, Lee Kyung-Goo, Kim Min Ki
Department of Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea.
Department of Surgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
Ann Surg Treat Res. 2023 Jun;104(6):325-331. doi: 10.4174/astr.2023.104.6.325. Epub 2023 Jun 7.
The number of elderly patients, especially aged ≥80 years, undergoing emergency surgery is gradually increasing. The aim of this study was to find out the trends and results of emergency general surgery for elderly patients over 9 years in an emergency medical center in South Korea, where the population is aging most rapidly.
The clinical characteristics, outcomes, and medical expenses of emergency general surgery for the elderly (aged 65-79 years) and highly elderly (aged ≥80 years) patients who visited to a regional emergency medical center from 2012 to 2020 were analyzed.
The number of highly elderly patients increased with each 3-year interval, whereas the proportion of patients aged 19-79 years was similar, and that of pediatric patients was decreasing. The higher the age group, the higher the mortality (young adult elderly highly elderly: odds ratio [OR], 1 3.689 11.293; P < 0.001) and complication rates (OR, 1 2.840 4.633; P < 0.001), and longer length of hospital stay (β = 0.949, P = 0.001) even after adjusting for the type of surgery and the American Society of Anesthesiologists physical status classification. Non-covered medical expenses were significantly related to the age groups (β = 151,608.802, P < 0.001).
The higher age group was associated with increased number of unfavorable outcomes after emergency general surgery, along with increased medical cost. Efforts to prevent emergency surgery for elderly patients and a specialized treatment system are needed.
接受急诊手术的老年患者数量，尤其是年龄≥80岁的患者数量正在逐渐增加。本研究的目的是了解韩国一个人口老龄化速度最快的急诊医疗中心9年来老年患者急诊普通外科手术的趋势和结果。
分析了2012年至2020年期间前往某地区急诊医疗中心的老年（65 - 79岁）和高龄（≥80岁）患者急诊普通外科手术的临床特征、结局和医疗费用。
每3年间隔，高龄患者数量增加，而19 - 79岁患者的比例相似，儿科患者的比例在下降。年龄组越高，死亡率越高（青年成人＜老年＜高龄：比值比[OR]，1＜3.689＜11.293；P＜0.001）和并发症发生率越高（OR，1＜2.840＜4.633；P＜0.001），即使在调整手术类型和美国麻醉医师协会身体状况分类后，住院时间也更长（β = 0.949，P = 0.001）。非医保医疗费用与年龄组显著相关（β = 151,608.802，P＜0.001）。
年龄组越高，急诊普通外科手术后不良结局的数量增加，同时医疗成本也增加。需要努力预防老年患者的急诊手术并建立专门的治疗系统。
