Morbidity and mortality of emergency surgery in octogenarian patient.

OBJECTIVE

To evaluate the health outcomes (postoperative morbidity and mortality) and the functional status at discharge of elderly patients older than 80 years who underwent emergency surgery.

METHOD

Patients > 80 years of age who underwent emergency surgery during one year at the Marqués de Valdecilla University Hospital, Santander, Spain. Preoperative data (age, sex, type of surgery, comorbidity) and postoperative data (complications) were evaluated, as well as in-hospital mortality, at 30 days and 6 months after surgery.

RESULTS

Five-hundred-sixty-eight patients underwent emergency surgery between 2018 and 2019. After the review, 407 patients were included in the study. Average age: 86.9 years. Women 61.7%. Mean hospital stay: 10.4 days. Traumatic interventions 41.3%, vascular surgery 19.7%, general-digestive surgery 25.3%. Medium ASA risk: 2.88. Functional status at discharge: 3.15. Postoperative complications: Clavien-Dindo I 40.8%, II 40.3%, IIIA 3.4%, IIIB 2.5%, IVA 3.9%, IVB 2.0% and V 7.1%. Hospital mortality 7.1%, 30-day mortality 10.3%, mortality at 6 months 24.6%.

CONCLUSIONS

Patients > 80 years of age undergoing urgent surgery have high preoperative comorbidity, postoperative complications, and high mortality at 30 days and 6 months after surgery. This mortality is more significant in those ASA IV, nonagenarians and those undergoing high-risk surgery.