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Surgery and Old Age: An Age Old QuestionComment on "Identification of Specific Quality Improvement Opportunities for the Elderly Undergoing Gastrointestinal Surgery"
Jeffrey B. Matthews, MD
Arch Surg. 2009;144(11):1020.
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Is advanced age a contraindication to a major operation? The literature is rife with reports that purport to show that even complex procedures may be carried out safely in elderly patients with otherwise limited comorbidities. The authors of this study mined the ACS-NSQIP database to directly address this question. They convincingly demonstrate that after controlling for other preoperative factors, age remains a strong independent predictor of morbidity and mortality after major gastrointestinal procedures. The increased risk with advancing age is largely attributable to differences in cardiac, pulmonary, and urologic complications, which suggests opportunities to improve the quality of surgical care in the elderly with measures beyond current initiatives directed at surgical site infection and deep venous thrombosis. Although multi-institutional databases are inherently limited by the consistency of data gathering, the greater sample size and the ability to sample experience across both academic and community centers are . . . [Full Text of this Article]
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Identification of Specific Quality Improvement Opportunities for the Elderly Undergoing Gastrointestinal Surgery
David J. Bentrem, Mark E. Cohen, Denise M. Hynes, Clifford Y. Ko, and Karl Y. Bilimoria
Arch Surg. 2009;144(11):1013-1020.
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