Cheng K W, Wang C H, Ho R T, Jawan B, Lee J H
Department of Anesthesiology, Chang Gung Memorial Hospital, Kaohsing.
Acta Anaesthesiol Sin. 1994 Mar;32(1):37-43.
We studied retrospectively the outcome of surgery and anesthesia in 294 patients aged 80 and older who underwent 362 surgical procedures. Of these, 52 cases (14.4%) were admitted to intensive care unit (ICU) post-operatively. The 48-hour, 48-hour-to-30-day and overall mortality rates were 0.8%, 3.8% and 5.2% respectively. ICU. admission and mortality rate were closely associated with the ASA physical status classification. The overall mortality rates were 1.3%, 5.7% and 27% in class II, III and IV respectively. The respective ICU admission rates were 3%, 20% and 56%. ICU admission rate and mortality rate were 42.5% and 13.8% in emergency surgery vs. 5.8% and 2.5% in elective surgery. Patients with 3 or more co-existing diseases had the mortality rate of 23% and the rates of ICU admission and mortality for those with 3 or more peri-operative complications were 22% and 16% respectively vs. 11% and 4% for those with 2 or less peri-operative complications. General surgery was associated with the highest mortality rate (15%) than other type of procedures. 22 of 74 cases who underwent intra-abdominal surgery required controlled ventilation for more than 24 hours post-operatively. 59% (13 cases) of such cases could not weaned successfully from ventilators and died subsequently. Only 2.5% (7 cases) of cases who underwent extra-pleural and extra-peritoneal procedures required controlled ventilation for more than 24 hours post-operatively. Of these, 2 died subsequently. For comparison, the study were artificially divided into two phases, each of three years long: they were the period from 1986-1988 and the period from 1989-1992.(ABSTRACT TRUNCATED AT 250 WORDS)
我们回顾性研究了294例80岁及以上患者接受362例外科手术的手术及麻醉结果。其中，52例（14.4%）术后入住重症监护病房（ICU）。48小时、48小时至30天及总体死亡率分别为0.8%、3.8%和5.2%。ICU入住率及死亡率与美国麻醉医师协会（ASA）身体状况分类密切相关。II、III和IV级患者的总体死亡率分别为1.3%、5.7%和27%。相应的ICU入住率分别为3%、20%和56%。急诊手术的ICU入住率和死亡率分别为42.5%和13.8%，择期手术则为5.8%和2.5%。患有3种或更多并存疾病的患者死亡率为23%，围手术期有3种或更多并发症患者的ICU入住率和死亡率分别为22%和16%，而围手术期有2种或更少并发症患者则为11%和4%。普通外科手术的死亡率（15%）高于其他类型手术。74例接受腹部手术的患者中有22例术后需要控制通气超过24小时。其中59%（13例）无法成功脱机并随后死亡。接受胸膜外和腹膜外手术的患者中只有2.5%（7例）术后需要控制通气超过24小时。其中2例随后死亡。为作比较，该研究人为分为两个阶段，每个阶段为期三年：即1986 - 1988年期间和1989 - 1992年期间。（摘要截选至250字）
