Ariño P, Castano J, Castillo J, Sierra P, Sánchez-Ortega J M, Vila J
Servicio de Anestesiologá, Hospital de l'Esperança, Barcelona.
Rev Esp Anestesiol Reanim. 1996 Mar;43(3):89-93.
To determine wether the physical status (ASA category) and surgical conditions could predict mortality in elderly general surgery patients.
This was a prospective study of patients greater than or equal 85 years of age who underwent elective or emergency surgery under general anesthesia between January 1987 and December 1991. Hospital mortality was defined as death occurring before discharge. Logical regression analysis (Cox's modeling) was used to assess group survival.
One hundred and nine patients undergoing 117 operations were enrolled. Major surgery was performed in 70%; 44% were removals of malignant tumors and 84% were under general anesthesia. Hospital deaths occurred in 10%; the only significant predictors were neoplastic disease and emergency status. Mortality was 43% one year after surgery; significant predictors of death were prior physical status, neoplasia and emergency status.
Neoplastic disease, emergency status and poor physical condition are factors that predict mortality in patients 85 or older who undergo general surgery.
确定身体状况（美国麻醉医师协会分级）和手术条件能否预测老年普通外科手术患者的死亡率。
这是一项对1987年1月至1991年12月期间接受全身麻醉下择期或急诊手术的85岁及以上患者的前瞻性研究。医院死亡率定义为出院前死亡。采用逻辑回归分析（Cox模型）评估组生存率。
109例患者接受了117台手术。70%为大手术；44%为恶性肿瘤切除，84%在全身麻醉下进行。医院死亡率为10%；唯一显著的预测因素是肿瘤疾病和急诊状态。术后一年死亡率为43%；死亡的显著预测因素是术前身体状况、肿瘤形成和急诊状态。
肿瘤疾病、急诊状态和身体状况差是85岁及以上接受普通外科手术患者死亡率的预测因素。
