Faculty Opinions recommendation of Postoperative mortality in parathyroid surgery in Sweden during five decades: improved outcome despite older patients.

600 Background: The incidence of early onset CRC is rising. Little is known about the clinicopathological differences between younger and older Egyptian (EGY) adults with CRC. Herein we explore these differences. Methods: A retrospective review of younger EGY adult (YA; ≤ 46 years) and older EGY adult (OA; > 65 years) patients (pts) with CRC was performed. T and Fisher’s exact tests were used for comparative analyses. Kaplan-Meier methodology estimated survival. Results: In total, 997 EGY pts with CRC were studied, including 443 YA (median age 35 years; range 15-46) and 153 OA pts (median 70 years range 65-84).There were no statistically significant differences with respect to gender, degree of tumor differentiation, extracolonic extension, stage at presentation, or patterns of metastasis between the two groups. YA pts had more rectal primaries compared with OA pts (49% vs. 31%, p < 0.001), whereas older pts had more colon primaries (69% vs. 51%, p < 0.001). Additionally YA pts had more left-sided tumors (78% vs. 62%, p < 0.001) compared with OA pts, whereas older pts had more right-sided tumors (32% vs. 17%, p < 0.001). YA pts were more likely to have mucin-producing tumors (40% vs. 23%, p = 0.003). Although there were no differences in the proportion of pts presenting with metastatic disease (28% [YA] vs. 32% [OA], p = 0.615), or the pattern of metastasis to the liver, lung, or peritoneum (40% vs. 50%, p = 0.288; 5% vs. 6%, p = 1.00, 16% vs. 17%, p = 1.00), YA were more likely to have CRC-related lymph node (LN) involvement (mean: 3.2 vs. 1.6, p = 0.006). There were no differences in PFS (Median: 12 months for YA vs. 13 months for OA) or OS (median: 76 months for YA vs. not reached for OA) between the two groups. However male YA pts had a better OS that female pts (median OS not reached in males, 72 months in females). Conclusions: Significant differences were evident between YA and OA pts with CRC, notably locations of primary tumors. Male had improved outcome compared to female YA patients. Additional evaluation of the molecular features of CRC in young and older patients in Egypt is warranted.

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Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study

European Geriatric Medicine ◽

10.1007/s41999-017-0002-6 ◽

2017 ◽

Vol 9 (1) ◽

pp. 51-59 ◽

Cited By ~ 2

Author(s):

Danica Markovic ◽

Tatjana Jevtovic-Stoimenov ◽

Milena Stojanovic ◽

Anita Vukovic ◽

Vesna Dinic ◽

...

Keyword(s):

Pilot Study ◽

Older Patients ◽

Postoperative Mortality ◽

Prediction Performance ◽

Risk Scores ◽

Physical Status ◽

Physical Status Classification ◽

Status Classification ◽

American Society ◽

American Society Of Anesthesiologists

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EVALUATION OF INDICATORS CHARACTERIZING INPATIENT SURGICAL CARE DELIVERY TO OLDER PATIENTS IN THE RUSSIAN FEDERATION

Social Aspects of Population Health ◽

10.21045/2071-5021-2021-67-5-5 ◽

2021 ◽

Vol 67 (5) ◽

pp. 5

Author(s):

S.I. Shlyafer ◽

◽

I.B. Shikina ◽

Keyword(s):

Postoperative Complications ◽

Older Patients ◽

Care Delivery ◽

Postoperative Mortality ◽

Surgical Care ◽

Fold Increase ◽

High Tech ◽

Number Of Patients ◽

The Russian Federation ◽

High Technologies

Significance: Population ageing challanges the majority of the world including the Russian Federation. Older people are more subject to operative interventions, including high tech interventions. The purpose of the study is to analyze indicators characterizing the level of surgical care deivery to older patients in the Russian hospitals in 2011-2019. Material and methods. Indicators characterising surgical care delivery in hospitals were analyzed including: the number of patients operated; the number of operations performed, including high tech interventions; the number of deaths after surgery, including after high tech interventions; frequency of postoperative complications; postoperative mortality among older patients (women - 55 years and older, men - 60 years and older). The authors used data of the federal statistical observation form No. 14 "Information onabout performance of units of medical organizations providing inpatient medical care" for the period from 2011 to 2019. Statistical (calculations of extensive and intensive indicators) and analytical methods were applied. Results. The share of older patients out of all patients operated in 2019 in the Russian hospitals equalled to 35.2% (vs 23.1% in 2011), including high tech interventions (18.9% of all operations). Conclusion: among older patients the study has identified: an 18.8% increse in the number of patients discharged from hospitals; a 5.6% increase in the number of patients operated; a 63.5% increase in the number of operations in the hospital, including a 2.6 fold increase in the number of operations using high technologies; a 73.4 % increase in the number of operated patients who died in the hospital; including a 3.8 fold increase in the number of patients died after operations using high technologies; postoperative mortality rate of patients increased from 2.21 to 2.39%. The rate of postoperative complications associated with all operations decreased from 1.06 to 0.64%, including decrease from 1.74 to 0.97% in postoperative complications associated with operations using high technologies.

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Successful Acute Type A Aortic Dissection Repair in a Nonagenarian

The Heart Surgery Forum ◽

10.1532/hsf98.2014329 ◽

2014 ◽

Vol 17 (3) ◽

pp. 178

Author(s):

Edward Ansari ◽

Alexander Blehm ◽

Udo Boeken ◽

Arthur Lichtenberg

Keyword(s):

Aortic Dissection ◽

Older Patients ◽

Surgical Repair ◽

Postoperative Mortality ◽

Type A ◽

Acute Type ◽

Patient History ◽

Type A Aortic Dissection ◽

Postoperative Course ◽

Aggressive Surgical Approach

Surgical repair in older patients with acute type A aortic dissection (ATAAD) evokes a higher peri- and postoperative mortality, it therefore remains controversial in nonagenarians. The authors present a case of a surgically managed ATAAD in a nonagenerian, a 94-year-old man presented with an uncomplicated ATAAD, necessitating emergency surgical repair. The subsequent postoperative course was uneventful, and the patient was discharged after uncomplicated recovery. Aggressive surgical approach should be feasable in select nonagenarian patients with ATAAD, depending on the clinical presention and prior patient history.

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All-cause 30-day postoperative mortality for older patients in developed countries presenting for elective colorectal surgery: a systematic review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2013-995 ◽

2013 ◽

Vol 11 (8) ◽

pp. 159-169 ◽

Cited By ~ 1

Author(s):

Joanna Sutherland ◽

Suzanne Robertson-Malt ◽

Cindy Stern

Keyword(s):

Systematic Review ◽

Colorectal Surgery ◽

Older Patients ◽

Postoperative Mortality ◽

Developed Countries ◽

Systematic Review Protocol ◽

Elective Colorectal Surgery ◽

Review Protocol

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Postoperative mortality in parathyroid surgery in Sweden during five decades: improved outcome despite older patients

Acta Endocrinologica ◽

10.1530/eje-08-0523 ◽

2009 ◽

Vol 160 (2) ◽

pp. 295-299 ◽

Cited By ~ 9

Author(s):

S Norenstedt ◽

A Ekbom ◽

L Brandt ◽

J Zedenius ◽

I-L Nilsson

Keyword(s):

Mortality Rate ◽

Elderly Patients ◽

Mortality Risk ◽

Age Groups ◽

Postoperative Mortality ◽

Premature Death ◽

Safe Procedure ◽

Parathyroid Surgery ◽

Perioperative Mortality ◽

Swedish Population

ObjectivePrimary hyperparathyroidism (pHPT) is a common endocrine disorder. In Europe, pHPT has been associated with premature death in cardiovascular disorders. Our question was whether the risk of postoperative death has been affected by the increased proportion of elderly patients referred for parathyroid surgery.MethodsThe nationwide Cancer Registry and Causes-of-Death Registry were used to analyze mortality among 14 635 Swedish patients subjected to parathyroid adenomectomy (PTx) during 1961–2004. Standard mortality ratios (SMR) and the 95% confidence intervals (CI) were calculated with the entire Swedish population as control, standardized for age, gender and calendar year.ResultsThe observation period was more than 166 000 person-years. The overall perioperative (30-day) mortality rate was 1.3% (185/14 635; SMR 7.9; CI 6.82–9.15); 1.1% for women (132/11 500; SMR 7.56; CI 6.32–8.96), and 1.7% for men (53/3135; SMR 9.01; CI 6.75–11.78). Cardiovascular disorder was the dominant cause of death in both sexes and in all the investigated age groups (age 15–54 years; SMR 29.0; CI 9.42–67.71, age 55–74 years; SMR 6.12; CI 3.96–9.03, age 75 years: SMR 5.26; CI 3.74–7.19). The SMR decreased over the calendar year period notwithstanding a rising proportion of elderly individuals. In the most recent period, 1997–2004, the perioperative mortality rate was only 0.5%, which represents a normalization of the excess mortality risk during the first post-PTx year (SMR 1.17; CI 0.92–1.46).ConclusionPTx is a safe procedure, regardless of patient age. Today, the perioperative mortality risk is not a reason for excluding elderly patients from parathyroid surgery.

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