Surgical Outcomes in Different Age Cohorts Undergoing Abdominal Surgery: A Retrospective Study

Vjollca Shpata; Krenar Lilaj; Nertila Kodra

doi:10.1016/j.jopan.2023.08.023

Surgical Outcomes in Different Age Cohorts Undergoing Abdominal Surgery: A Retrospective Study

J Perianesth Nurs. 2023 Nov 21:S1089-9472(23)00942-5. doi: 10.1016/j.jopan.2023.08.023. Online ahead of print.

Authors

Vjollca Shpata¹, Krenar Lilaj², Nertila Kodra³

Affiliations

¹ Faculty of Rehabilitation Sciences, University of Sports of Tirana, Tirana, Albania. Electronic address: vjollca.hajro@yahoo.com.
² Faculty of Medicine, University of Medicine, Tirana, Albania; University Hospital Center of Tirana "Mother Theresa", Tirana, Albania.
³ University Hospital Center of Tirana "Mother Theresa", Tirana, Albania.

PMID: 37999690
DOI: 10.1016/j.jopan.2023.08.023

Abstract

Purpose: This study aimed to investigate and compare the surgical outcomes of younger and older patients after abdominal surgery and explore risk factors related to postoperative complications and in-hospital mortality in patients ≥65 years old.

Design: A retrospective study on 540 adult patients who underwent abdominal surgery and stayed more than 48 hours in the hospital.

Methods: The two groups of patients: younger than 65 years and ≥65 years old were compared related to postoperative complications, length of hospital stay, and mortality rates. The cohort of patients aged ≥65 years was selected to analyze risk factors for complications occurrence and in-hospital mortality.

Findings: Patients ≥65 years old had poorer outcomes after abdominal surgery than younger patients. Pre-existence of comorbidities, American Society of Anesthesiologists physical status classification greater than two, emergency admission, and low preoperative serum albumin levels were risk factors for postoperative complications and mortality in elderly patients. Other risk factors for in-hospital mortality were the age ≥75 years, obesity, postoperative serum albumin level less than 30 g/L, presence of anemia before and after surgery, and occurrence of postoperative complications. Logistic regression revealed as independent risk factors for the postoperative complications the American Society of Anesthesiologists' physical status classification greater than two (odds ratio [OR]: 3.05, 95% confidence interval [CI]: 1.63-5.67, P = .0004) and preoperative serum albumin levels lower than 30 g/L (OR: 2.12, 95% CI: 1.08-4.17, P = .02), while for in-hospital postoperative mortality, independent risk factors were postoperative anemia (OR: 4.13; 95% CI: 1.22-13.97, P = .02) and obesity (OR: 7.65, 95% CI: 2.59-22.57, P = .0002).

Conclusions: Optimizing the preoperative conditions of older patients will improve their postoperative outcomes, especially for patients ≥75 years old, with obesity, comorbidities, anemia, severe nutritional risk, and emergency admission.

Keywords: complications; elderly; in-hospital mortality; postoperative outcome.