Factors associated with adverse outcome following urologic surgery in patients aged 80 years and older

Aging Clin Exp Res. 2013 Apr;25(1):75-9. doi: 10.1007/s40520-013-0011-3. Epub 2013 Apr 3.

Abstract

Background and aims: This study was designed to find predictors for adverse post-operative outcomes in elderly patients aged 80 years and older, who underwent urologic surgery.

Methods: In this prospective observational study, we analysed data, including age, gender, American Society of Anesthesiologists (ASA) class, co-morbidities, number of regular medications, type and extent of surgery, type of anesthesia, duration of surgery and hospitalization, post-operative morbidity and mortality. We studied the correlations between each pre- and intra-operative parameter to the consequence, to find predictors for adverse outcome.

Results: During a 12-month period, 217 patients underwent 294 urologic procedures in our institution. Ninety-eight procedures (33%) were followed by complications and 11 patients (5%) died. Patients who had uneventful surgery and hospitalization were significantly younger than those who experienced morbidity or mortality. There was a significantly higher complication rate among patients with a higher ASA class or with ischemic heart disease, following higher graded or longer operations, and after emergency surgery.

Conclusions: Older age is a significant risk factor. Patients with higher ASA class or ischemic heart disease are at higher risk for post-operative complications and thus, require careful follow-up. In this age population, extensive or prolonged surgery should be carefully considered.

MeSH terms

  • Aged, 80 and over
  • Female
  • Humans
  • Israel / epidemiology
  • Male
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Urologic Surgical Procedures / adverse effects
  • Urologic Surgical Procedures / mortality*