Original scientific articleSurgical Risk Factors, Morbidity, and Mortality in Elderly Patients
Section snippets
Methods
The University of Virginia Health System Institutional Review Board approved this study. The NSQIP, developed in the Veterans Administration, provided the well-described definitions and methodology.18, 19 The University of Virginia Health System has participated in the NSQIP from February 24, 2002, to the present. Surgical Clinical Nurse Reviewers systematically record preoperative, intraoperative, and postoperative variables of surgical patients. Previous publications provide detailed
Results
We recorded 7,916 major surgical procedures in the University of Virginia Health System ACS-NSQIP data set, and 7,696 eligible procedures were performed on 6,953 patients. One thousand seven hundred one (1,701) patients underwent multiple procedures (range 2 to 13), with 220 occurring during the same hospitalization, and were removed. Emergent operations accounted for 16% (1,198 of 7,696) of procedures; 24% (1,815 of 7,696) of patients did not have a preoperative risk factor; and female
Discussion
Increasing age itself is an important risk factor for surgical candidates. Surgical morbidity exhibited a linear increase across all age groups. Between ages 18 and 69, morbidity rate and risk factors increased similarly by increments with age. At ages 70 and older, morbidity increased by decade without increasing preoperative risk factors. Surgical mortality increased exponentially across all age groups when morbidity exhibited linear increases and when preoperative risk factors ceased
Acknowledgment
We thank Clifford Y Ko, MD, MS, MSHS, for his critical review of this article; Bart D Phillips, BS, for calculating the mortality rate equation; and William G Henderson, PhD, MPH for sharing the development of the NSQIP’s statistical model.
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Competing Interests Declared: None.