OUTCOME FOLLOWING COLON SURGERY IN THE OCTAGENARIAN

The results of colon surgery in all individuals aged 80 years or great er at one teaching institution during the 1987-1993 time period were r eviewed. Sixty patients, ranging in age from 80 to 92 years, underwent 41 elective operations and 21 emergency procedures. Emergency procedu res resulted in death or a major complication in over one-half of pati ents, and only six were ultimately able to return home. Conversely, el ective procedures were relatively well tolerated, and 31 of 37 survivo rs returned immediately to independent living (P = 0.006). Mortality w as 33.3 per cent in emergency cases versus 9.8 per cent in elective op erations (P < 0.03). The occurrence of a postoperative complication in creased the length of stay by an average of 12 days. These data sugges t that elective colon surgery in the elderly produces results little d ifferent from the population at large. Conversely, emergency operation s are associated with a high morbidity and mortality rate. Age alone s hould not be a determining factor in who undergoes an elective colon o peration, Greater efforts should be made to screen elderly individuals to limit emergency surgery.