SURGICAL CARE AND OUTCOMES AFTER ABDOMINAL SURGERY IN THE ELDERLY PATIENTS OVER 90 YEARS OLD

概要

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This study evaluated the safety of abdominal surgery in elderly patients over 90 years old. Between January 1993 and December 2004, 21 patients over 90 years old (18 females and 3 males, mean age; 92.4 years old, range 90 to 99) underwent laparotomy in our institution. Of those, 20 patients demonstrated preoperative morbidities and 14 had cardiovascular diseases. Of 8 patients with malignancies, radical surgery was performed in 3 patients and palliative surgery was performed in 5 patients. The rate of postoperative morbidity was as high as 95.2% (20/21), and there were many cases showing respiratory complication, delirium, and disuse atrophy. Although the surgical mortality rate was only 9.5% (2/21), the overall hospital-death rate was 42.9% (9/21). Of 12 patients discharged from hospital, 4 patients could not take meals or walk by themselves. In conclusion, it is difficult to say that abdominal surgery in the elderly patients over 90 years old has been performed safely, considering the poor prognosis shown by the overall hospital-death rate of over 40%. We should try to improve the prognosis and emphasize early discharge from hospital along with return to social life with a feeling of confidence.
日本臨床外科学会の論文