Postoperative complications in the elderly surgical patient

Abstract

1. 1. A review of 723 operations performed upon patients sixty years of age or over on the general surgical service showed that 523 were major operations, of which 35 per cent were followed by one or more postoperative complications. This compared to a 23 per cent complication rate in patients under sixty years of age for the same time period. The complication rate for minor surgery in the elderly patients was 11 per cent compared to 4 per cent in the younger patients. 2. 2. The mortality rate following major surgery in the patients sixty years of age and over was 8.5 per cent compared to 4 per cent in the patients under sixty years of age. Pulmonary complications were the most frequently encountered type in those patients who died postoperatively. 3. 3. More complications arose in the elderly male than in the elderly female patient. 4. 4. Wound and gastrointestinal complications were the most frequent encountered. 5. 5. Extreme obesity (30 per cent or more above ideal weight) was associated with a higher complication rate but moderately obese patients had no increase in complications. 6. 6. Atelectasis was three times more common in elderly patients than in patients under sixty years of age. 7. 7. The need is pointed out for more accurate recording of postoperative complications if proper steps are to be taken to reduce our current complication rate.