Causes of Postoperative Death in the Octogenarian 2015

Author(s):
Georgina Alizo Arruebarrena; Jason Sciarretta; Leslie Hart; Sharon Holmes; John Davis

Background:

The elderly population is a rapidly growing group in the US with exponentially increasing surgical needs. While preoperative risk in this population has been studied, little data is available on the causes of post-operative death in the octogenarian and nonagenarian.

Hypothesis:

The cause of death in the elderly is due to progressice chronic disease

Methods:

We retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database for 2015 focusing on procedures and post-operative diagnosis. We divided the study population into three main categories depending on the type of surgery received: emergent, elective and urgent (non-emergent, non-elective).  Two subgroups were identified within these groups based on the patient’s functional status: independent and dependent. We examined patient demographics, preoperative risk factors, 30-day mortality, and post-operative complications in patients aged 80 years and older.

Results:

We identified 25,892 patients with a mortality rate of 3.9%.  Of the 1001 deaths, 598 (59.74%) were seen in the emergent surgery group, 140 (13.98%) in the elective group, and 263 (26.23%) in the urgent group. When comparing cause of death, a majority was due to acute abdomen 815 (81.41%). Death associated with cancer was seen in 186 patients (18.59%). See Figure.

An comparison of complications between emergent and elective was done and the data is shown in 2nd Figure.