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Older Adults May Have Higher Risk of Complications, Death After Abdominal Surgery CHICAGO -- December 21, 2009 -- The risk of complications and early death after commonly performed abdominal surgical procedures appears to be higher among older adults, according to a study published in the December issue of Archives of Surgery. “Approximately 2 million older Americans undergo abdominal surgical operations each year,” the authors wrote. “For clinicians, patients and families considering abdominal surgical procedures, informed decision making is challenging because of limited data regarding the risks of adverse perioperative events associated with advancing age.” Nader N. Massarweh, MD, University of Washington School of Medicine, Seattle, Washington, and colleagues examined complication and death rates of 101,318 adults aged 65 years or older who underwent common abdominal procedures such as cholecystectomy, hysterectomy, and colectomy from 1987 to 2004. Complications were recorded within 90 days of discharge and deaths were recorded within 90 days of hospital admission. The 90-day complication rate was 17.3% and the 90-day death rate was 5.4%. “Advancing age was associated with increasing frequency of complications (65-69 years, 14.6%; 70-74 years, 16.1%; 75-79 years, 18.8%; 80-84 years, 19.9%; 85-89 years, 22.6%; and >= 90 years, 22.7%) and mortality (65-69 years, 2.5%; 70-74 years, 3.8%; 75-79 years, 6%; 80-84 years, 8.1%; 85-89 years, 12.6%; and >= 90 years, 16.7%),” the authors wrote. “After adjusting for demographic, patient and surgical characteristics as well as hospital volume, the odds of early postoperative death increased considerably with each advance in age category. These associations were found among patients with both cancer and noncancer diagnoses and for both elective and nonelective admissions.” “Older adults may be less able to adapt to the stress of surgery or to the added stress of any postoperative complication, greatly increasing their risk of early mortality,” the authors concluded. “These effects appear to be additive, highlighting the need for interventions to both prevent decline among older patients and avoid postsurgical complications.” SOURCE: Archives of Surgery E-mail this page to a friend or colleague! To print, use this version