Open hepatic resection in the elderly at two tertiary referral centers

Am J Surg. 2021 Sep;222(3):594-598. doi: 10.1016/j.amjsurg.2021.01.024. Epub 2021 Jan 21.

Abstract

Background: Surgeons are being increasingly called upon to operate on the very elderly. This study aimed to evaluate outcomes following hepatectomy in patients ≥80 years of age at two tertiary care centers.

Methods: All adult patients who underwent liver resection from 2001 to 2017 were included. Primary outcome was 90-day postoperative mortality. Secondary outcomes included 30-day postoperative mortality and postoperative complications.

Results: Between 2001 and 2017, 2397 patients underwent liver resection. On unadjusted analysis, patients ≥80 years of age had higher rates of 90-day mortality (13.3% vs. 3.6%, p < 0.001), 30-day mortality (5.6% vs. 1.8%, p = 0.01), MI (7.9% vs. 3.5%, p = 0.04), and UTI (10.0% vs. 4.5%, p = 0.02). On multivariable analysis, age ≥80 years was significantly associated with 90-day postoperative mortality (OR 4.51, 95%CI 2.11-9.67, p < 0.001).

Conclusions: Across these two major referral tertiary care centers, very elderly patients had higher rates of 90-day and 30-day postoperative mortality on both unadjusted and adjusted analyses.

Keywords: Elderly; Hepatectomy; Liver resection; Morbidity; Mortality; Octogenarian.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Aged, 80 and over
  • Chi-Square Distribution
  • Female
  • Hepatectomy / methods
  • Hepatectomy / mortality*
  • Hepatectomy / statistics & numerical data
  • Humans
  • Male
  • Massachusetts
  • Multivariate Analysis
  • Postoperative Complications / epidemiology
  • Tertiary Care Centers*
  • Time Factors