SURGERY IN THE VERY OLD PATIENT - EVALUATION OF FACTORS LINKED TO POSTOPERATIVE MORBIDITY AND MORTALITY

One hundred and sixty-seven patients over 79 years of age were studied prospectively in our Emergency Surgery Department in order to evaluat e their outcome, and the possible existence of factors linked to morbi dity and mortality. The most common indications for surgery were gal(s tones (22.1%), hernias (14.9%), colo-rectal cancer (13.7%), peptic ulc er (6.5%), gastric cancer (5.9%) and ischemic or hemorrhagic vascular diseases (13.1%). Emergency surgery was performed in 93 (55.6%) patien ts. Forty-nine patients (29.3%) developed 83 postoperative complicatio ns. The risk of morbidity was statistically higher in patients who had more than two associated diseases (p<0.05) and received blood transfu sions (p<0.01). The mortality rate was 16.1%, and was significantly re lated to ASA scores greater than or equal to 4 (p<0.001) and a high de gree of intraoperative bacterial contamination (Classes III-IV) (p<0.0 5). Compared to elective surgery, emergency operations had a higher mo rbidity (33.3% vs 24.3%) and mortality (21.5% vs 9.4%), but the differ ence was not significant. Mortality/morbidity ratio was significantly higher in emergency, as compared to elective surgery (64.5% vs 38.8%, p<0.001).