Xin yixue (Aug 2023)

Perioperative management and prognosis in over aged patients undergoing non-cardiac surgery： experience with 828 cases in a single center

  • Wu Dehua, Wang Weixing, Shi Yanxuan, Tang Jiawen, Zhu Tao

DOI
https://doi.org/10.3969/j.issn.0253-9802.2023.08.012
Journal volume & issue
Vol. 54, no. 8
pp. 590 – 594

Abstract

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Objective To investigate perioperative management and prognosis in patients aged≥80 years old undergoing non-cardiac surgery. Methods Clinical data of 828 patients aged≥80 years old undergoing non-cardiac surgery were retrospectively analyzed. Intraoperative hypotension， accumulated time of hypotension， operation time， intraoperative blood loss， postoperative ICU admission， length of ICU stay， length of hospital stay， cost of care， perioperative complications need to be treated， and perioperative death were recorded and analyzed. Results The mean age of 828 patients was （84±4） years old. All cases were classified as American Society of Anesthesiologist （ASA） gradeⅡ-Ⅴ. Postoperative complications occurred in 111 patients （13.4%）， and postoperative death occurred in 24 patients （2.9%）. The incidence of postoperative complications and death in thoracic， neuro-，and vascular surgery was 29% and 17%， the highest among various types of operations （all P < 0.05）. Among patients with different ASA grades， the incidence of postoperative complications and death in patients with ASA gradeⅣand V was significantly higher than that in their counterparts with ASA gradeⅡ（both P < 0.001）. The selection of anesthesia approach did not affect the incidence of postoperative complications and death in different operations except thoracic， neuro-， and vascular surgery under general anesthesia （P > 0.05）. Compared with patients with intraoperative systolic pressure of <120 mmHg， the incidence of postoperative complications was significantly higher in those with systolic pressure of < 90 mmHg（P < 0.05）. The proportion of ICU admission， length of hospital stay， and incidence of postoperative complications were significantly increased over age （all P < 0.01）， whereas postoperative death rate did not differ among patients of different ages （P > 0.05）. Conclusions Patients aged≥80 years old have high incidence of postoperative complications and death rates， which is probably associated with high-risk operation and intraoperative hypotension， especially systolic hypotension of < 90 mmHg enduring for≥10 min.

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