Abdominal surgery is carried out on two million older Americans every year. One factor that should be considered when proposing abdominal surgery is the increased risk of complications and mortality in the older patient after these operations. A team from the University of Washington School of Medicine, Seattle, has carried out a study of complications and death rates after abdominal surgery in a group of 101,318 adults aged 65 or more. The abdominal surgery included operations like gall bladder removal, hysterectomy and colectomy. They recorded complications occurring within 90 days of discharge from hospital and deaths occurring within 90 days of hospital admission.
The overall complication rate was 17.3% and the mortality rate was 5.4%. The risk of complications after abdominal surgery went up with age. Between 65 and 69 it was 14.6% but at age 90 or more it was 22.7%. A similar trend was found with mortality following abdominal surgery. It was 2.5% in the 65 to 69 age group but rose to 16.7% in those aged 90 or older. It may be that the stress of abdominal surgery is just so much greater for an older body. Therefore, doctor and patient must decide whether abdominal surgery is really necessary (of course, it may be essential for survival) and, if so, how post-operative complications may best be avoided.
Source:
Massarweh N et al Impact of advancing age on abdominal surgical outcomes Archives of Surgery December 2009;144:1108-1114
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