Abstract
BackgroundDementia often adversely affects postoperative outcomes in surgical patients. This study evaluated postoperative outcomes among elderly patients with and without dementia undergoing early cholecystectomy for acute cholecystitis (AC).MethodsA total of 182 patients over 85 years of age who were diagnosed with AC and treated from January 2005 to March 2018 were reviewed retrospectively; 59 patients who underwent early cholecystectomy were enrolled. The complication rates, length of postoperative hospital stay, and rates of routine discharge (i.e., returning to their preoperative living location) were compared between two groups of patients with and without dementia.ResultsThe overall complication rate after early cholecystectomy for AC in 59 patients was 11.9%, and there was no mortality in this series. The median postoperative hospital stay was 9.0 days, and the routine discharge rate was 89.8%. Of the 59 patients, 22 patients (37.3%) had a history of dementia. Complication rates were comparable between the groups, despite the rate of delirium development being significantly higher in the dementia group. The median length of postoperative hospital stay and routine discharge rates did not significantly differ between groups.ConclusionsEarly cholecystectomy for patients with AC over 85 years of age was performed safely, and elderly patients with dementia had similar postoperative outcomes as compared with patients without dementia.
Highlights
Dementia often adversely affects postoperative outcomes in surgical patients
Regardless of older age and impaired cognitive status, acute cholecystitis (AC) is considered to be an indication for emergency surgery in our department, if patients are recommended for early cholecystectomy as the first-line treatment of AC by the emergency room assessment based on the Tokyo Guidelines [1, 2]
This study demonstrated that an early cholecystectomy for patients with AC over 85 years of age could be performed safely, and elderly patients with dementia had similar postoperative outcomes concerning complication rates, postoperative hospital stay, and routine discharge rates as compared with patients without dementia
Summary
Dementia often adversely affects postoperative outcomes in surgical patients. This study evaluated postoperative outcomes among elderly patients with and without dementia undergoing early cholecystectomy for acute cholecystitis (AC). Acute cholecystitis (AC) is a disease that usually requires emergency intervention, because it can lead to a number of serious and potentially fatal complications without treatment. In young and otherwise healthy patients, early cholecystectomy is accepted as the gold standard of treatment for AC. In elderly patients (i.e., over 65 years of age), whether early cholecystectomy should be conducted as the firstline treatment for AC is still debated, given their various. When undergoing general anesthesia and surgical interventions, patients with dementia are at a high risk of developing postoperative complications that can lead to a prolonged hospital stay [5, 6]. A history of dementia affects the decision for surgery for patients, their families, and surgeons [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
