Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)
| Autor: | J. Martin, Busayo Irojah, Theodore Bell, Vanita Ahuja, Rodney Grim |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Context (language use) 030230 surgery 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Cholecystectomy In patient education Retrospective Studies Aged 80 and over education.field_of_study business.industry General surgery Outcome measures Retrospective cohort study General Medicine Length of Stay Surgical procedures Original Research & Contributions United States Acs nsqip Surgery 030220 oncology & carcinogenesis Female business |
| Zdroj: | The Permanente Journal. 21 |
| ISSN: | 1552-5775 1552-5767 |
| DOI: | 10.7812/tpp/16-013 |
| Popis: | CONTEXT Cholecystectomy is the most common general surgery procedure in patients older than age 65 years. By 2050, it is estimated that 2.0% of the population will be older than age 90 years. OBJECTIVE To assess the mortality of cholecystectomy in superelderly patients (≥ age 90 years). DESIGN Using the American College of Surgeons National Surgical Quality Improvement Program database, a retrospective analysis was performed of superelderly patients who underwent laparoscopic and open cholecystectomy between 2005 and 2012. MAIN OUTCOME MEASURES Thirty-day mortality. RESULTS A total of 1007 cholecystectomies were performed in superelderly patients between 2005 and 2012. Of these surgical procedures, 807 (80%) were nonemergent and 200 (20%) were performed emergently. Two hundred sixteen procedures (21.4%) were open and 791 (78.6%) were laparoscopic. Mortality did not decrease significantly during the study period. The overall mortality was 5.5%, significantly less for the laparoscopic group (3.7% vs 12%, p < 0.001) and for the nonemergent group (4.5% vs 9.5%, p < 0.005). The median length of stay for open cholecystectomy was 9 days compared with 5 days for laparoscopic (p < 0.001); for nonemergent cholecystectomy it was 5 days compared with 7 days for emergent cholecystectomy (p < 0.001). CONCLUSION The mortality after cholecystectomy in superelderly patients did not change significantly during the study period. The mortality and morbidity for laparoscopic and elective procedures were significantly lower than for open procedures and for emergent procedures, respectively. |
| Databáze: | OpenAIRE |
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