Indications for emergency surgery for perforated diverticulitis in elderly Japanese patients ≥80 years of age

Surg Today. 2013 Oct;43(10):1150-3. doi: 10.1007/s00595-013-0514-8. Epub 2013 Feb 19.

Abstract

Purpose: Perforated diverticulitis (PD) remains a serious acute abdominal condition. The aim of this study was to evaluate indications for emergency surgery in patients ≥80 years of age with PD.

Method: Twenty patients ≥80 years of age and 28 younger patients who underwent emergency surgery for PD from January 2002 to December 2011 were studied. The demographics and postoperative outcomes were compared.

Results: The preoperative characteristics, mortality rate, and postoperative complications were similar between these two groups. All seven patients ≥80 years of age with an American Society of Anesthesiologists (ASA) score of 2 survived after surgery. All five patients with a Mannheim peritonitis index (MPI) score of ≥26 in the elderly group died after surgery. There were significant associations between the mortality, the MPI and ASA score in patients ≥80 years of age.

Conclusions: Best supportive care may be an alternative for patients ≥80 years of age with PD, an ASA score of ≥3 or an MPI score of ≥26.

MeSH terms

  • Age Factors
  • Aged, 80 and over
  • Asian People
  • Digestive System Surgical Procedures* / mortality
  • Diverticulitis, Colonic / mortality
  • Diverticulitis, Colonic / surgery*
  • Emergencies
  • Emergency Treatment* / mortality
  • Female
  • Health Status Indicators*
  • Humans
  • Intestinal Perforation / mortality
  • Intestinal Perforation / surgery*
  • Male
  • Peritonitis / mortality
  • Severity of Illness Index*