Surgery Acceptable for Very Elderly
Urological surgery performed on patients aged 80 years and older does not pose unacceptably high risks, even if they have comorbidities, Japanese researchers have concluded.
The finding is based on an analysis of data from 255 patients in this age group who underwent urological surgery between 1975 and 2004 and for whom detailed clinical records were available. Investigators divided the 30-year span into five-year increments to examine trends.
Of the 255 patients, 225 (88.3%) had at least one comorbidity and 51 (20%) experienced postoperative complications, according to a report in the International Journal of Urology (2008;15:789-793). The complication rate did not differ significantly from one five-year increment to another. The most frequent complication was delirium, which occurred in 25 patients. Male gender and open surgery were risk factors for postoperative complications, each increasing the risk by more than threefold.
The 255 patients were part of a larger cohort of 402 patients analyzed by the researchers for surgical trends. Data showed that the number of surgeries performed on patients aged 80 years and older increased every five years.
Comparing the interval from 1975-1979 and the interval from 2000-2004, the proportion of such surgeries relative to all surgeries performed rose from 1.6% to 4.6%. The proportion of open surgeries declined from 30% to 13.3%. An increase in the number of endourological surgeries for urological malignancies probably accounted for the decline in the percentage of open surgeries, the researchers said.