From the Department of General Surgery (Alselaim, Alsuhaibani, bin Gheshayan, Albreakeit, Alhassan, Alharbi), King Saud Bin Abdulaziz University for Health Science, College of Medicine; and from King Abdullah International Medical Research Center (Alselaim), Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2023 Jul;44(7):661-666. doi: 10.15537/smj.2023.44.7.20220916.
To assess the outcomes of emergency colorectal surgeries in elderly patients over the age of 65 years.
This is a retrospective chart review study. We studied 99 patients over the age of 65 years and 142 patients younger than 65 years who underwent emergency colorectal surgery at our institute. In this study, patient demographics, operative results, length of hospital stay, and survival were analyzed.
Emergency colorectal surgery was performed on a total of 145 men and 96 women. Patients over the age of 65 years were found to have a significantly greater proportion of pulmonary, cardiac, and endocrine comorbidities (27.3%, 84.8%, and 65.7%, respectively). The mean length of hospital stay was 26.0±32.1 days in the group of elderly patients and 17.8±22.0 days in the group of patients under the age of 65. The length of postoperative hospital stay was significantly greater in the group of elderly patients with a -value (0.00). The length of hospital stay in the intensive care unit was 8.86±17.1 days, which was longer in the group of elderly patients, while it was 3.65±11.4 days for the group of younger patients. However, after logistic regression, the difference in the length of post-operative hospital and intensive care unit stays between elderly and non-elderly patients was not statistically significant in elderly patients.
Our study suggests that the elderly population are associated with longer hospital stay and higher rates of postoperative pulmonary and cardiovascular complications compared to those under the age of 65. However, after logistic regression, age by itself was not found to be an independent risk factor for worse outcome indicating that patient comorbidities as a whole increase the risk of worse outcomes. Therefore, the care of elderly patients undergoing emergency colorectal surgery should be individualized based on several factors rather than age alone.
评估 65 岁以上老年患者急诊结直肠手术的结局。
这是一项回顾性图表研究。我们研究了在我院接受急诊结直肠手术的 99 名 65 岁以上和 142 名 65 岁以下的患者。在这项研究中,分析了患者的人口统计学特征、手术结果、住院时间和生存情况。
共有 145 名男性和 96 名女性接受了急诊结直肠手术。结果发现,65 岁以上患者的肺部、心脏和内分泌合并症比例明显更高(分别为 27.3%、84.8%和 65.7%)。老年组的平均住院时间为 26.0±32.1 天,而 65 岁以下组为 17.8±22.0 天。老年组的术后住院时间明显更长,P 值为 0.00。老年组重症监护病房的住院时间为 8.86±17.1 天,高于年轻组的 3.65±11.4 天。然而,经过逻辑回归后,老年患者和非老年患者在术后住院和重症监护病房住院时间方面的差异无统计学意义。
与 65 岁以下患者相比,老年患者的住院时间更长,术后肺部和心血管并发症发生率更高。然而,经过逻辑回归后,年龄本身并不是预后不良的独立危险因素,这表明患者的合并症整体上增加了不良结局的风险。因此,对接受急诊结直肠手术的老年患者的治疗应根据多个因素进行个体化,而不仅仅是年龄。