Surgical mortality among the elderly. An analysis of 4,050 operations (1970-1974).

The overall surgical mortality rate of 3.4 percent in 32,308 operations (22,288 patients) between 1970 and 1974 was essentially the same as the 3.7 percent recorded for 30,241 operations (22,967 patients) during the preceding 5 years. The surgical mortality rate among patients 70 years or older fell significantly (p less than 0.005) from 6.8 percent of 3,754 procedures (2,766 patients) during the 1965--1969 period to 4.8 percent of 4,050 procedures (2, 783 patients) between 1970 and 1974. There was a 50 percent increase in operative mortality from all causes among the elderly when compared to the rates of 4.7 percent of patients and 3.2 percent of procedures observed in patients under the age of 70. If the patients in whom the surgical procedure seemed incidental to their death from other causes are excluded, the mortality rate among the elderly was a more realistic 2.8 percent of procedures (114 patients) between 1970 and 1974. The 30-day mortality rate from all causes noted in this group was 3.7 percent of procedures, or 5.4 percent of patients. These results appear to justify the philosophy that age alone is no contraindication to potentially curative cancer surgery, and demonstrate that such surgery can be performed with acceptable mortality rates.