The differential effects of surgical harm in elderly populations. Does the adage: “they tolerate the operation, but not the complications” hold true? - 22/09/14
, Jennifer Ritz, R.N., Ryan Kather, B.S., Pat Patton, M.D., Jack Jordan, M.S., Roberta Mooney, R.N., M.S., Harriette Mathilda Horst, M.D., F.A.C.S., Ilan Rubinfeld, M.D., M.B.A., F.A.C.S.Abstract |
Background |
Elderly patients are thought to tolerate surgical complications poorly because of low physiologic reserve. The purpose of the study was to evaluate the differential effects of surgical harm in patients over 80 years old.
Methods |
Three years of data from a harm-reduction campaign were used to identify inpatient surgeries performed on patients older than 50. The rates of harm, death, cost, and length of stay (LOS) were analyzed using SPSS 21 (IBM, New York, NY).
Results |
A total of 22,710 patients were identified. Rates of harm and mortality increased with increasing age. Harmed patients over age 80 had increased mortality (9.5% vs 7%), but lower cost, intensive care unit days, and LOS versus those aged 50 to 80. Linear regression showed increased cost with harm ($24,000) and decreased cost with age above 80 (−$7,000).
Conclusions |
In the elderly surgical population, there is more harm and harm events are associated with higher mortality rates, but less additional cost and LOS. Differing goals or aggressiveness of care may explain cost avoidance in the elderly.
Le texte complet de cet article est disponible en PDF.Keywords : Elderly, Harm, Outcomes, Cost
Plan
| The authors have no financial relationships with industry or other organizations to disclose and this study was not sponsored. |
Vol 208 - N° 4
P. 656-662 - octobre 2014 Retour au numéro
Article précédent
- Readmissions after ileostomy closure: cause to revisit a standardized enhanced recovery pathway?
- Deborah S. Keller, Brian Swendseid, Sadaf Khan, Conor P. Delaney
- Actual versus estimated length of stay after colorectal surgery: which factors influence a deviation?
- Usama Ahmed Ali, Tony Dunne, Brooke Gurland, Jon D. Vogel, Ravi P. Kiran
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?