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The outcomes of the elderly in acute care general surgery

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old.

Methods

A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student’s t test for continuous variables and Fisher’s exact test for categorical variables using STATA 12 (College Station, TX, USA).

Results

We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (p < 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (p < 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (p = 0.05), increased postoperative complications (p = 0.002), admission to the ICU (p = 0.002), and were more likely to receive a non-operative procedure (p = 0.003). No difference was found (p = NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition.

Conclusions

Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.

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Conflict of interest

Etienne St-Louis declares that he has no conflict of interest. Monisha Sudarshan declares that she has no conflict of interest. Mohamed Al-Habboubi declares that he has no conflict of interest. Muhamad El-Husseini Hassan declares that he has no conflict of interest. Paola Fata declares that she has no conflict of interest. Dan Leon Deckelbaum declares that he has no conflict of interest. Tarek Razek declares that he has no conflict of interest. Liane Feldman declares that she has no conflict of interest. KosarKhwaja declares that he has no conflict of interest.

Ethical standard

The present study was approved by the McGill University Health Centre (MUHC) Ethics Review Board. This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada

    E. St-Louis, M. Sudarshan, M. Al-Habboubi, M. El-Husseini Hassan, D. L. Deckelbaum, T. S. Razek, L. S. Feldman & K. Khwaja

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  1. E. St-Louis
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  2. M. Sudarshan
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  3. M. Al-Habboubi
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  4. M. El-Husseini Hassan
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  5. D. L. Deckelbaum
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  6. T. S. Razek
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  7. L. S. Feldman
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  8. K. Khwaja
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Correspondence to E. St-Louis.

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St-Louis, E., Sudarshan, M., Al-Habboubi, M. et al. The outcomes of the elderly in acute care general surgery. Eur J Trauma Emerg Surg 42, 107–113 (2016). https://doi.org/10.1007/s00068-015-0517-9

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  • DOI: https://doi.org/10.1007/s00068-015-0517-9

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