Emergency operations in elderly patients: morbidity and mortality

in this study, the risks of emergency surgical procedures in elderly patients and the effect of surgery on the morbidity and mortality were investigated. The records of 884 patients, those who were 65 years old or elder, and who were operated on in the Department of Surgery, University of Selçuk beetwen May 1991 and April 1997 were analyzed, retrospectively. One hundred eighty three patients (20.7%) were operated on urgently and 701 patients (79.3%) were elective. The ratio of male ifemale was 1.9 (120M/63F) and the mean age was 72.3 (range 65-95) in the emergency operations. Most frequent reason for the emergency operations were intestinal obstruction (49 cases), acute mesenteric ischemia (24 cases) and pepic ulcer perforation (23 cases). Mean hospital stay was 10.8 days (3-51 days) in the emergency and 7.2 days (1-41 days) in the elective operation (p<0.0001). The mor-tality was 18.6% in the emergency and 3.4% in the elective operations (p<0.0001). There was no correlation bet-ween mortality rates in different age groups (p>0.05). The highest mortality was observed in intraabdominal abs-cess and in perforated gallbladder disease. Intestinal resection and anastomosis was performed in 55.9% of expired cases. The majority of the patients (70.6%), who had died, had coexisting cardiopulmonary diseases. The main causes of death in alt patients were sepsis and cordio-pulmonary diseases. The main causes of death in all patients were sepsis and cardio-pulmonary failure. In conclusion, age is not a contraindication for an emergency operation and does not affect mortality which appears to be directly related to the severity and nature of the di-sease and to the coexisting cordio-pulmonary diseases. For this reason, timing is very important in the operations of elderly patients, and it is wise to perform the most conservative operation in some severe surgical conditions.