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Surgical Endoscopy
Erschienen in: Surgical Endoscopy 5/2016

21.07.2015

The impact of postoperative complications on the recovery of elderly surgical patients

verfasst von: Mehdi Tahiri, Tarifin Sikder, Geva Maimon, Debby Teasdale, Fadi Hamadani, Nadia Sourial, Liane S. Feldman, Jack Guralnick, Shanon A. Fraser, Sebastian Demyttenaere, Simon Bergman

Erschienen in: Surgical Endoscopy | Ausgabe 5/2016

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Abstract

Background

While the negative impact of postoperative complications on hospital costs, survival, and cancer recurrence is well known, few studies have quantified the impact of postoperative complications on patient-centered outcomes such as functional status. The objective of this study was to estimate the impact of postoperative complications on recovery of functional status after elective abdominal surgery in elderly patients.

Methods

Elderly patients (70 years and older) undergoing elective abdominal surgery, with a planned length of stay >1 day, were prospectively enrolled between July 2012 and December 2014. The primary outcome was time to recovery to the preoperative functional status measured by the short physical performance battery (SPPB) preoperatively and at 1 week, 1, 3, and 6 months after surgery. The comprehensive complication index was calculated to grade the severity and number of postoperative complications. A Weibull survival model with interval censoring was performed, controlling for age, sex, body mass index (BMI), comorbidities (Charlson comorbidity index−CCI), frailty, presence of cancer, nutritional status, wound class, preoperative functional status, and surgical approach.

Results

Hundred and forty-nine patients (79 men and 70 women) were included in the analysis. Mean age was 77.7 ± 4.9 years, mean BMI was 27.2 ± 5.5 kg/m2, and the median CCI was 3 (IQR 2–6). The mean preoperative SPPB score was 9.62 ± 2.33. A total of 52 patients (34.9 %) experienced one or more postoperative complications, including four mortalities, and a total of 72 complications. The mean comprehensive complication index score for these patients was 25.7 ± 23.8. In the presence of all other variables included in the model, a higher comprehensive complication index score was found to significantly decrease the hazard of recovery (HR 0.96, CI 0.94–0.98, p value = 0.0004) and hence increase the time to recovery.

Conclusion

Following elective abdominal surgery, elderly patients who experience a greater number and more severe postoperative complications take longer to return to their preoperative functional status.
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Metadaten
Titel
The impact of postoperative complications on the recovery of elderly surgical patients
verfasst von
Mehdi Tahiri
Tarifin Sikder
Geva Maimon
Debby Teasdale
Fadi Hamadani
Nadia Sourial
Liane S. Feldman
Jack Guralnick
Shanon A. Fraser
Sebastian Demyttenaere
Simon Bergman
Publikationsdatum
21.07.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 5/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4440-2

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