For the purpose of highlighting the problems that arise in emergency s
urgical procedures in elderly patients and of defining safe management
, the records of 797 patients aged over 70, operated urgently during a
22-year period, were reviewed. The mortality was 18.4% in the emergen
cy and 4.5% in the elective operations (p<0.0001). There was no correl
ation between mortality rates in different age groups, The majority of
the patients (67.3%) with coexisting cardio or pulmonary diseases exp
ired. The mortality was significantly lower in the second 11-year peri
od (1982-1992) (14%) than in the first one (1971-1981) (23.8%), (p<0.0
001). In conclusion, age is not a contraindication for an emergency op
eration and does not affect mortality which appears to be directly rel
ated to the severity and nature of the disease and to the coexisting c
ardio pulmonary diseases. We must advise the elderly to be operated on
timely, In some severe surgical conditions it is wise to perform ad h
oc the most conservative operation.