Journal Article10.1093/AGEING/18.5.316
A Prospective Study of Elderly General Surgical Patients: II. Post-operative Complications
D. G. Seymour,F. G. Vaz +1 more
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TL;DR: It appears that pre-operative medical fitness rather than chronological age is the main determinant of post-operative outcome in the elderly surgical patient.
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Abstract: A prospective study was carried out on 288 general surgical patients aged 65 years and over. Over 40% of patients suffered no post-operative complication. The commonest post-operative problem was respiratory, with 17% of patients having simple atelectasis, 12% acute bronchitis and 10% pneumonia. Six per cent of patients developed post-operative heart failure and/or myocardial infarction. Delirium was noted post-operatively in 7% of patients, and new focal neurological signs in 1%. The post-operative hospital fatality rate was 5% (4% when deaths due to carcinomatosis were excluded). Nine patients out of ten spent less than a month in hospital. The relation of post-operative morbidity and mortality to seven factors was examined: type of surgery, urgency of surgery, urgency of admission, age, number of pre-operative medical diagnoses, American Society of Anesthetists' grade, and pre-operative mobility level. It appears that pre-operative medical fitness rather than chronological age is the main determinant of post-operative outcome in the elderly surgical patient.
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Citations
The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis.
John G.F. Cleland,Karl Swedberg,Ferenc Follath,Michel Komajda,Alain Cohen-Solal,J.C. Aguilar,Rainer Dietz,Antonello Gavazzi,R. Hobbs,Jerzy Korewicki,Hugo Madeira,V. S. Moiseyev,István Préda,W. H. Van Gilst,J Widimsky,Nick Freemantle,Joanne Eastaugh,James Mason +17 more
TL;DR: Most men but a minority of women who underwent investigation of cardiac function had evidence of moderate or severe left ventricular dysfunction, the main target of current advances in the treatment of heart failure.
Preoperative pulmonary risk stratification for noncardiothoracic surgery: Systematic review for the American College of Physicians
TL;DR: A 2-part systematic review to guide clinicians on clinical and laboratory predictors of perioperative pulmonary risk before noncardiothoracic surgery and to evaluate the efficacy of strategies to reduce the risk for postoperative pulmonary complications is prepared.
Delirium risk factors in elderly hospitalized patients
TL;DR: In this paper, the authors identify through systematic literature review the risk factors associated with the development of delirium in hospitalized geriatric patients, but results have been quite variable and unreliable.
Frailty is associated with postoperative complications in older adults with medical problems.
TL;DR: It is suggested that a frailty screen can refine risk estimates of postoperative complications in older adults undergoing elective non-cardiac surgery.
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Postoperative Delirium: A Review of 80 Primary Data-Collection Studies
TL;DR: This article conducted an on-line search and manual search for 1966 through 1992 to determine the incidence, diagnosis, risk factors, and treatment of postoperative delirium and found that the incidence was 36.8% (range, 0% to 73.5%).
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