Adverse events in ambulatory surgery. A comparison between elderly and younger patients

Purpose: An increasing number of elderly patients are undergoing ambulatory surgery. We examined whether ambulatory surgery carries a higher risk for the elderly than for younger patients. Methods: A total of 17,638 consecutive ambulatory surgical patients were en rolled in a prospective cohort study during a three-year period. Preoperati ve, intraoperative, and postoperative information was collected. Twenty-sev en percent of the enrolled patients were 65 yr or older. Incidence rates of intraoperative and postoperative adverse events among the elderly were com pared with those among younger patients; we controlled for sex, ASA physica l status, body mass index, type of surgery, and duration of procedure, usin g multiple logistic regression models. Results: Elderly patients had a higher incidence of any intraoperative even t (adjusted odds ratio, 1.4; 99.7% confidence interval [CI], 1.0-2.0) and o f intraoperative cardiovascular events (adjusted odds ratio, 2.0; 99.7% CI, 1.3-3.0). They also had a lower incidence of any postoperative event (adju sted odds ratio. 0.4; 99.7% CI, 0.3-0.6) and of postoperative pain (adjuste d odds ratio, 0.2; 99.7% CI, 0.1-0.4), nausea and vomiting (adjusted odds r atio. 0.3; 99.7% CI, 0.1-0.6), and dizziness (adjusted odds ratio. 0.4; 99. 7% CI, 0.2-1.0). Conclusion: The risks reported do not constitute a contraindication for eld erly patients to undergo ambulatory surgery but this population may require more careful intraoperative cardiovascular management.