Postoperative morbidity and mortality in the elderly [MORBILITA E MORTALITA POSTOPERATORIA IN CHIRURGIA GERIATRICA]

Abstract The authors report their experience and review the literature concerning postoperative results in geriatric surgery. Clinical charts from 210 patients older than 70 year operated for cholelytiasis (56 cases), inguinal/crural hernia (47 cases), colo-rectal cancer (46 cases), gastric cancer (15 cases), breast cancer (11 cases), miscellaneous conditions (35 cases) were reviewed. Postoperative complications were reported in 32 patients (15.2%) with a mortality rate of 7.6% (16 patients). An higher morbidity and mortality were observed in emergency surgery (20% and 14% respectively) compared to elective operations. Surgery for gastric cancer and benign disease of gallbladder and/or CBD was associated with higher morbidity and mortality too. In addition, morbidity and mortality resulted directly related to surgical risk Index of Reiss (0:7.1% and 1.7%; 1:21.5% and 9.2%; 2:30.3% and 24.2% respectively. Our results seem to confirm, similarly to other authors, that age older than 85 years, emergency surgery, laparotomy, ASA. Index IV or V, peritonitis or intestinal infarction and advanced neoplastic disease, represent significant risk factors for surgery in elderly patients. Such risk factors should be better controlled according to our experience, in order to reduce the high morbidity and mortality in elderly patients.