TY - JOUR
T1 - Outcomes of Surgery in Patients 90 Years of Age and Older
AU - Hosking, Michael P.
AU - Warner, Mark A.
AU - Lobdell, Creig M.
AU - Offord, Kenneth P.
AU - Melton, L. Joseph
PY - 1989/4/7
Y1 - 1989/4/7
N2 - During the 11-year period 1975 through 1985, seven hundred ninety-five patients 90 years of age and older underwent operative procedures at the Mayo Clinic, Rochester, Minn. Overall serious morbidity within 48 hours after surgery was 9.4%, and the mortality was 1.6%. The 30-day, 1-year, and 5-year mortality rates were 8.4%, 31.4%, and 78.8%, respectively. Short-term morbidity and both short- and long-term mortality were highly associated with the American Society of Anesthesiologists physical status classification of the patient. Emergency procedures carried a significantly higher risk for morbidity and mortality within the 48-hour period and, to a lesser extent, for long-term mortality. Overall, poorer patient survival was associated with higher American Society of Anesthesiologists class; male sex; preoperative renal, liver, and central nervous system impairment; and surgery on the mouth, nose, or pharynx. When compared with age-, sex-, and calendar Year-matched peers from the general population, there was a modest decrease in patient survival at 1 year that reversed by 2 years, with observed survival at 5 years comparable to the rate expected.
AB - During the 11-year period 1975 through 1985, seven hundred ninety-five patients 90 years of age and older underwent operative procedures at the Mayo Clinic, Rochester, Minn. Overall serious morbidity within 48 hours after surgery was 9.4%, and the mortality was 1.6%. The 30-day, 1-year, and 5-year mortality rates were 8.4%, 31.4%, and 78.8%, respectively. Short-term morbidity and both short- and long-term mortality were highly associated with the American Society of Anesthesiologists physical status classification of the patient. Emergency procedures carried a significantly higher risk for morbidity and mortality within the 48-hour period and, to a lesser extent, for long-term mortality. Overall, poorer patient survival was associated with higher American Society of Anesthesiologists class; male sex; preoperative renal, liver, and central nervous system impairment; and surgery on the mouth, nose, or pharynx. When compared with age-, sex-, and calendar Year-matched peers from the general population, there was a modest decrease in patient survival at 1 year that reversed by 2 years, with observed survival at 5 years comparable to the rate expected.
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U2 - 10.1001/jama.1989.03420130077027
DO - 10.1001/jama.1989.03420130077027
M3 - Article
C2 - 2926926
AN - SCOPUS:0024598743
SN - 0098-7484
VL - 261
SP - 1909
EP - 1915
JO - JAMA: The Journal of the American Medical Association
JF - JAMA: The Journal of the American Medical Association
IS - 13
ER -