scholarly journals COMPARISON OF ANESTHETIC METHODS FOR POSTOPERATIVE COMPLICATIONS IN EMERGENCY ABDOMINAL SURGERY FOR ELDERLY PATIENTS

1994 ◽  
Vol 55 (5) ◽  
pp. 1137-1142
Author(s):  
Hidenori TAKAHARA ◽  
Tatsuo MAGARIBUCHI
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Emergency Abdominal Surgery

Sarcopenia predicts 90-day mortality in elderly patients undergoing emergency abdominal surgery

2019 ◽  
Vol 44 (3) ◽  
pp. 1155-1160 ◽  
Author(s):  
Erik Brandt ◽  
Line Toft Tengberg ◽  
Morten Bay-Nielsen
Keyword(s):  
Abdominal Surgery ◽  
Elderly Patients ◽  
Emergency Abdominal Surgery

scholarly journals Preoperative serum albumin level as a predictor of surgical complications after emergency abdominal surgery

2019 ◽  
Vol 6 (2) ◽  
pp. 361
Author(s):  
Sharath Kumar V. ◽  
Dhruva G. Prakash ◽  
Venkatasiva Krishna Pottendla
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Tertiary Care ◽  
Total Mortality ◽  
Albumin Level ◽  
Morbidity And Mortality ◽  
Preoperative Serum ◽  
Emergency Abdominal Surgery

Background: Hypoalbumenia has been shown to be associated with increased morbidity and mortality in acute surgical patients due to increased catabolism. This study intends to correlate between hypoalbumenia and postoperative complications in patients undergoing emergency abdominal surgery.Methods: A prospective study is done in a rural tertiary care centre in a total of 190 patients undergoing emergency abdominal surgery after obtaining ethical clearance. In this study preoperative serum albumin and postoperative complications including death up to postoperative day thirty were recorded and gathered using a checklist designed for the study and analysed. Serum albumin less than 3.5g/dl is considered as hypoalbumenia in this study. The correlation between preoperative serum albumin and postoperative morbidity and mortality is assessed.Results: In a total of 190 patients, 93 (48.9%) patients had morbidity and 27 (14.2%) patients had mortality. Preoperative serum albumin less than 3.5g/dl is found in 120 (63.1%) cases and 70 (36.9%) patients has same or more than 3.5g/dl. Patients with preoperative serum albumin less than 3.5g/dl has morbidity in 87 (45.8%) patients than that of normal preoperative serum albumin level which is 6 (3.1%) cases (p= <0.0001, chi-square =72.31). The total mortality is 27 (14.2%) in which all mortality is found in low albumin group compared to no mortality in patients with normal serum albumin. As the albumin level decreases the risk of morbidity and mortality increases with majority of complication in this study occurring in patients with albumin group less than 2.5g/dl to 3g/dl.Conclusions: Preoperative serum albumin is a good predictor of surgical outcome after emergency abdominal surgery.

Sarcopenia increases risk of long-term mortality in elderly patients undergoing emergency abdominal surgery

2017 ◽  
Vol 83 (6) ◽  
pp. 1179-1186 ◽  
Author(s):  
Erika L. Rangel ◽  
Arturo J. Rios-Diaz ◽  
Jennifer W. Uyeda ◽  
Manuel Castillo-Angeles ◽  
Zara Cooper ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Elderly Patients ◽  
Emergency Abdominal Surgery ◽  
Long Term Mortality

scholarly journals Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yingke He ◽  
Lydia Weiling Li ◽  
Ying Hao ◽  
Eileen Yilin Sim ◽  
Kai Lee Ng ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Observational Study ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Postoperative Morbidity ◽  
Preoperative Assessment ◽  
Major Abdominal Surgery ◽  
Assessment Clinic ◽  
Point Increase

Abstract Frailty is defined as diminished physiological reserve predisposing one to adverse outcomes when exposed to stressors. Currently, there is no standardized Frail assessment tool used perioperatively. Edmonton Frail Scale (EFS), which is validated for use by non-geriatricians and in selected surgical populations, is a candidate for this role. However, little evaluation of its use has been carried out in the Asian populations so far. This is a prospective observational study done among patients aged 70 years and above attended Preoperative Assessment Clinic (PAC) in Singapore General Hospital prior to major abdominal surgery from December 2017 to September 2018. The Comprehensive Complication Index (CCI) and Postoperative Morbidity Survey (POMS) were used to assess their postoperative morbidity respectively. Patient’s acceptability of EFS was measured using the QQ-10 questionnaire and the inter-rater reliability of EFS was assessed by Kappa statistics and Bland Altman plot. The primary aim of this study is to assess if frailty measured by EFS is predictive of postoperative complications in elderly patients undergoing elective major abdominal surgery. We also aim to assess the feasibility of implementing EFS as a standard tool in the outpatient preoperative assessment clinic setting. EFS score was found to be a significant predictor of postoperative morbidity. (OR 1.35, p < 0.001) Each point increase in EFS score was associated with a 3 point increase in CCI score. (Coefficient b 2.944, p < 0.001) EFS score more than 4 has a fair predictability of both early and 30-day postoperative complications. Feasibility study demonstrated an overall acceptance of the EFS among our patients with good inter-rater agreement.

scholarly journals Frailty and functional decline after emergency abdominal surgery in the elderly: a prospective cohort study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Hwee Leong Tan ◽  
Shermain Theng Xin Chia ◽  
Nivedita Vikas Nadkarni ◽  
Shin Yuh Ang ◽  
Dennis Chuen Chai Seow ◽  
...  
Keyword(s):  
Cohort Study ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
The Elderly ◽  
Functional Independence ◽  
Surgery In The Elderly ◽  
The Impact ◽  
Emergency Abdominal Surgery

Abstract Background Frailty has been associated with an increased risk of adverse postoperative outcomes in elderly patients. We examined the impact of preoperative frailty on loss of functional independence following emergency abdominal surgery in the elderly. Methods This prospective cohort study was performed at a tertiary hospital, enrolling patients 65 years of age and above who underwent emergency abdominal surgery from June 2016 to February 2018. Premorbid variables, perioperative characteristics and outcomes were collected. Two frailty measures were compared in this study—the Modified Fried’s Frailty Criteria (mFFC) and Modified Frailty Index-11 (mFI-11). Patients were followed-up for 1 year. Results A total of 109 patients were prospectively recruited. At baseline, 101 (92.7%) were functionally independent, of whom seven (6.9%) had loss of independence at 1 year; 28 (25.7%) and 81 (74.3%) patients were frail and non-frail (by mFFC) respectively. On univariate analysis, age, Charlson Comorbidity Index and frailty (mFFC) (univariate OR 13.00, 95% CI 2.21–76.63, p < 0.01) were significantly associated with loss of functional independence at 1 year. However, frailty, as assessed by mFI-11, showed a weaker correlation than mFFC (univariate OR 4.42, 95% CI 0.84–23.12, p = 0.06). On multivariable analysis, only premorbid frailty (by mFFC) remained statistically significant (OR 15.63, 95% CI 2.12–111.11, p < 0.01). Conclusions The mFFC is useful for frailty screening amongst elderly patients undergoing emergency abdominal surgery and is a predictor for loss of functional independence at 1 year. Including the risk of loss of functional independence in perioperative discussions with patients and caregivers is important for patient-centric emergency surgical care. Early recognition of this at-risk group could help with discharge planning and priority for post-discharge support should be considered.

Restrictive versus liberal fluid therapy in geriatric patients undergoing major abdominal surgery: a randomized controlled trial

2019 ◽  
Author(s):  
Bin Cai ◽  
JiaTong Chen ◽  
Yin Kang ◽  
Dongnan Yu ◽  
Jinfeng Wei ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Fluid Therapy ◽  
Geriatric Patients ◽  
Pragmatic Trial ◽  
Intravenous Fluid ◽  
Major Abdominal Surgery ◽  
Fluid Regimen ◽  
Significant Difference

Abstract BACKGROUND: The optimal fluid therapy in elderly patients undergoing major abdominal surgery remains unclear. Although some trials have reported a restrictive fluid therapy may lead to better outcomes, there is no evidence whether it is suitable for elderly patients. METHODS: In a double-blinded pragmatic trial, 107 elderly patients undergoing major abdominal surgery were randomized to receive either a liberal (L group) or restrictive intravenous-fluid therapy (R group) . The postoperative fluid therapy was similar in the two groups. The primary outcome was vital organ injury included Myocardial injury after noncardiac surgery (MINS) and acute kidney injury（AKI）, the secondary outcomes included hypotension needed intervention intraoperatively, length of stay (LOS) , death and other complications defined up to 30 days. Analysis was performed by intention-to-treat. RESULT: 50 patients in the L group had an average intravenous fluid of 1943ml, as compared to 1295.61ml in 57 patients in the R group (P<0.001). The baseline Characteristics and operative details were similar between the groups. Patients in the L group had a lower rate of AKI (10% vs 35.1%, P=0.002) and surgical-site infection (0 vs 10.5%, P=0.029) than in the R group；MINS (20% vs 20.8%, P=0.724) and the other postoperative complications showed no differences between two groups. One patient died in the R group. No significant difference was found for the length of hospital stay[median(range) L: 15(8-49) vs R: 17(8-80); P=0.27]. The follow-up was 30 days. CONCLUSION: In geriatric patients undergoing major abdominal surgery, a liberal fluid regimen was associated with a lower rate of AKI and postoperative infection than restrictive fluid regimen and did not increase the risk of postoperative complications. Trial registration: ChiCTR1800019022. Registered 21 October 2018

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