Outcomes of the Extreme Elderly Undergoing Anaesthesia and Surgery amongst Southeast Asians

Abstract

Introduction. With a rapidly ageing population in Singapore, we see an increasing number of elderly patients undergoing surgery, both elective and emergency. This study aims to look at the anaesthesia techniques employed in a subset of very elderly population undergoing surgery and their subsequent postoperative outcomes, in particular their 30-day mortality, postoperative complication rates, and length of hospital stays. Materials and Methods. We searched from our hospital records between 2012 and 2013 for patients equal to or older than 90 years old who have undergone surgery and retrospectively analysed the types of surgery and mode of anaesthesia used. Results. Sixty-two patients were identified. The mean age is 93.6 years. Majority were ASA 2 and ASA 3 patients. The most common type of surgery performed was orthopaedic, followed by vascular and urologic. Seven of the 62 patients required re-operations. Regional was the predominant anaesthetic technique employed, followed by general anaesthesia. Intraoperative hypotension was seen in 16 of the patients, all of whom recovered uneventfully. Hypothermia, desaturation, and hypertension were the top three complications observed in the recovery. Seventeen patients were admitted to a high-dependency facility postoperatively. The mean length of stay was 13.7 days. The 30-day mortality was 1.6 percent. Conclusions. We have provided a snapshot of very elderly patients coming for surgery. The results show that this group of elderly patients do well postoperatively with relatively low complication and 30-day mortality rates. The outcomes presented can be used as a guide for risk counseling in the perioperative period.