Djokovic J L, Hedley-Whyte J
JAMA. 1979 Nov 23;242(21):2301-6.
We studied the outcome of surgery in 500 patients over 80 years of age. Hospital mortality within one month of surgery was 6.2%. The American Society of Anesthesiologists class 1 to 5 preoperative evaluation scale was useful in predicting death--less than 1% of class 2 patients died, 4% of class 3, and 25% of class 4. Six of seven perioperative deaths were caused by mesenteric infarction. Myocardial infarction was the leading cause of postoperative death. Twenty-four percent of 141 patients who underwent upper abdominal surgery required controlled endotracheal ventilation for more than 24 hours postoperatively; 57% after intrathoracic surgery; and only 2% after surgery that did not enter pleura or peritoneum. Forty-seven patients underwent gallbladder surgery, and 27 peripheral underwent vascular surgery without any hospital fatality. Enflurane appears to be a safe general anesthetic for sick, elderly patients.
我们研究了500例80岁以上患者的手术结局。术后1个月内的医院死亡率为6.2%。美国麻醉医师协会1至5级术前评估量表有助于预测死亡情况——2级患者的死亡率不到1%，3级为4%，4级为25%。围手术期死亡的7例患者中有6例是由肠系膜梗死所致。心肌梗死是术后死亡的主要原因。141例接受上腹部手术的患者中有24%术后需要控制气管内通气超过24小时；开胸手术后这一比例为57%；而未进入胸膜或腹膜的手术后这一比例仅为2%。47例患者接受了胆囊手术，27例接受了外周血管手术，均无医院死亡病例。对于病情较重的老年患者，恩氟烷似乎是一种安全的全身麻醉药。
