The outcomes of the elderly in acute care general surgery
Introduction Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences i...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2016-02, Vol.42 (1), p.107-113 |
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| container_title | European journal of trauma and emergency surgery (Munich : 2007) |
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| creator | St-Louis, E. Sudarshan, M. Al-Habboubi, M. El-Husseini Hassan, M. Deckelbaum, D. L. Razek, T. S. Feldman, L. S. Khwaja, K. |
| description | Introduction
Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old.
Methods
A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly ( |
| doi_str_mv | 10.1007/s00068-015-0517-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1765113645</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3949853831</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-a5c23485a912e76d6597e05f44e86b6eb071fe20271bf5b451022612182fe9333</originalsourceid><addsrcrecordid>eNp1kE1Lw0AQhhdRbK3-AC-y4MVLdGa_khyl-AUFL_W8JOmktuSj7iaH_ns3pBYRPO0s88w7w8PYNcI9AsQPHgBMEgHqCDTGUXrCppgYGaWpwtNjLeWEXXi_DTAYLc7ZRBiQCUg9Zenyk3jbd0Vbk-dtybvwp2pFrtrzTcOzou-IF5kjvqaGXFZx37s1uf0lOyuzytPV4Z2xj-en5fw1Wry_vM0fF1GhlOiiTBdCqkRnKQqKzcroNCbQpVKUmNxQDjGWJEDEmJc6VxpBCIMCE1FSOF3O2N2Yu3PtV0--s_XGF1RVWUNt7y3GRiNKo3RAb_-g27Z3TbhuoJQRiRADhSNVuNZ7R6XduU2dub1FsINXO3q1wasdvNo0zNwckvu8ptVx4kdkAMQI-NBqgp9fq_9N_QauXX-E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1764628225</pqid></control><display><type>article</type><title>The outcomes of the elderly in acute care general surgery</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>St-Louis, E. ; Sudarshan, M. ; Al-Habboubi, M. ; El-Husseini Hassan, M. ; Deckelbaum, D. L. ; Razek, T. S. ; Feldman, L. S. ; Khwaja, K.</creator><creatorcontrib>St-Louis, E. ; Sudarshan, M. ; Al-Habboubi, M. ; El-Husseini Hassan, M. ; Deckelbaum, D. L. ; Razek, T. S. ; Feldman, L. S. ; Khwaja, K.</creatorcontrib><description>Introduction
Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old.
Methods
A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student’s
t
test for continuous variables and Fisher’s exact test for categorical variables using STATA 12 (College Station, TX, USA).
Results
We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (
p
< 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (
p
< 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (
p
= 0.05), increased postoperative complications (
p
= 0.002), admission to the ICU (
p
= 0.002), and were more likely to receive a non-operative procedure (
p
= 0.003). No difference was found (
p
= NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition.
Conclusions
Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-015-0517-9</identifier><identifier>PMID: 26038035</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cohort Studies ; Critical Care Medicine ; Emergencies ; Emergency Medicine ; Female ; General Surgery ; Hospital Mortality ; Hospitals, Teaching ; Humans ; Intensive ; Intensive Care Units - utilization ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Older people ; Original Article ; Outcome Assessment (Health Care) ; Postoperative Complications - epidemiology ; Postoperative Complications - mortality ; Retrospective Studies ; Risk Factors ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Surgical Procedures, Operative ; Teaching hospitals ; Traumatic Surgery ; Young Adult</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2016-02, Vol.42 (1), p.107-113</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-a5c23485a912e76d6597e05f44e86b6eb071fe20271bf5b451022612182fe9333</citedby><cites>FETCH-LOGICAL-c442t-a5c23485a912e76d6597e05f44e86b6eb071fe20271bf5b451022612182fe9333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-015-0517-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-015-0517-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26038035$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>St-Louis, E.</creatorcontrib><creatorcontrib>Sudarshan, M.</creatorcontrib><creatorcontrib>Al-Habboubi, M.</creatorcontrib><creatorcontrib>El-Husseini Hassan, M.</creatorcontrib><creatorcontrib>Deckelbaum, D. L.</creatorcontrib><creatorcontrib>Razek, T. S.</creatorcontrib><creatorcontrib>Feldman, L. S.</creatorcontrib><creatorcontrib>Khwaja, K.</creatorcontrib><title>The outcomes of the elderly in acute care general surgery</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Introduction
Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old.
Methods
A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student’s
t
test for continuous variables and Fisher’s exact test for categorical variables using STATA 12 (College Station, TX, USA).
Results
We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (
p
< 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (
p
< 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (
p
= 0.05), increased postoperative complications (
p
= 0.002), admission to the ICU (
p
= 0.002), and were more likely to receive a non-operative procedure (
p
= 0.003). No difference was found (
p
= NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition.
Conclusions
Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>Critical Care Medicine</subject><subject>Emergencies</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>General Surgery</subject><subject>Hospital Mortality</subject><subject>Hospitals, Teaching</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intensive Care Units - utilization</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Original Article</subject><subject>Outcome Assessment (Health Care)</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Surgical Procedures, Operative</subject><subject>Teaching hospitals</subject><subject>Traumatic Surgery</subject><subject>Young Adult</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kE1Lw0AQhhdRbK3-AC-y4MVLdGa_khyl-AUFL_W8JOmktuSj7iaH_ns3pBYRPO0s88w7w8PYNcI9AsQPHgBMEgHqCDTGUXrCppgYGaWpwtNjLeWEXXi_DTAYLc7ZRBiQCUg9Zenyk3jbd0Vbk-dtybvwp2pFrtrzTcOzou-IF5kjvqaGXFZx37s1uf0lOyuzytPV4Z2xj-en5fw1Wry_vM0fF1GhlOiiTBdCqkRnKQqKzcroNCbQpVKUmNxQDjGWJEDEmJc6VxpBCIMCE1FSOF3O2N2Yu3PtV0--s_XGF1RVWUNt7y3GRiNKo3RAb_-g27Z3TbhuoJQRiRADhSNVuNZ7R6XduU2dub1FsINXO3q1wasdvNo0zNwckvu8ptVx4kdkAMQI-NBqgp9fq_9N_QauXX-E</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>St-Louis, E.</creator><creator>Sudarshan, M.</creator><creator>Al-Habboubi, M.</creator><creator>El-Husseini Hassan, M.</creator><creator>Deckelbaum, D. L.</creator><creator>Razek, T. S.</creator><creator>Feldman, L. S.</creator><creator>Khwaja, K.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>The outcomes of the elderly in acute care general surgery</title><author>St-Louis, E. ; Sudarshan, M. ; Al-Habboubi, M. ; El-Husseini Hassan, M. ; Deckelbaum, D. L. ; Razek, T. S. ; Feldman, L. S. ; Khwaja, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-a5c23485a912e76d6597e05f44e86b6eb071fe20271bf5b451022612182fe9333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort Studies</topic><topic>Critical Care Medicine</topic><topic>Emergencies</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>General Surgery</topic><topic>Hospital Mortality</topic><topic>Hospitals, Teaching</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intensive Care Units - utilization</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Original Article</topic><topic>Outcome Assessment (Health Care)</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Surgical Procedures, Operative</topic><topic>Teaching hospitals</topic><topic>Traumatic Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>St-Louis, E.</creatorcontrib><creatorcontrib>Sudarshan, M.</creatorcontrib><creatorcontrib>Al-Habboubi, M.</creatorcontrib><creatorcontrib>El-Husseini Hassan, M.</creatorcontrib><creatorcontrib>Deckelbaum, D. L.</creatorcontrib><creatorcontrib>Razek, T. S.</creatorcontrib><creatorcontrib>Feldman, L. S.</creatorcontrib><creatorcontrib>Khwaja, K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>St-Louis, E.</au><au>Sudarshan, M.</au><au>Al-Habboubi, M.</au><au>El-Husseini Hassan, M.</au><au>Deckelbaum, D. L.</au><au>Razek, T. S.</au><au>Feldman, L. S.</au><au>Khwaja, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The outcomes of the elderly in acute care general surgery</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>42</volume><issue>1</issue><spage>107</spage><epage>113</epage><pages>107-113</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Introduction
Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old.
Methods
A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student’s
t
test for continuous variables and Fisher’s exact test for categorical variables using STATA 12 (College Station, TX, USA).
Results
We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (
p
< 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (
p
< 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (
p
= 0.05), increased postoperative complications (
p
= 0.002), admission to the ICU (
p
= 0.002), and were more likely to receive a non-operative procedure (
p
= 0.003). No difference was found (
p
= NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition.
Conclusions
Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26038035</pmid><doi>10.1007/s00068-015-0517-9</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1863-9933 |
| ispartof | European journal of trauma and emergency surgery (Munich : 2007), 2016-02, Vol.42 (1), p.107-113 |
| issn | 1863-9933 1863-9941 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Cohort Studies Critical Care Medicine Emergencies Emergency Medicine Female General Surgery Hospital Mortality Hospitals, Teaching Humans Intensive Intensive Care Units - utilization Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Older people Original Article Outcome Assessment (Health Care) Postoperative Complications - epidemiology Postoperative Complications - mortality Retrospective Studies Risk Factors Sports Medicine Surgery Surgical Orthopedics Surgical Procedures, Operative Teaching hospitals Traumatic Surgery Young Adult |
| title | The outcomes of the elderly in acute care general surgery |
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