TY - JOUR
T1 - Outcomes After Major Surgical Procedures in Octogenarians
T2 - A Nationwide Cohort Study
AU - Elfrink, Arthur K. E.
AU - Alberga, Anna J.
AU - van Berge Henegouwen, Mark I.
AU - Scheurs, Wilhelmina H.
AU - van der Geest, Lydia G. M.
AU - Verhagen, Hence J. M.
AU - Dekker, Jan-Willem T.
AU - Grünhagen, Dirk J.
AU - Wouters, Michel W. J. M.
AU - Klaase, Joost M.
AU - DICA Study Group
AU - Voeten, Daan M.
AU - Suurmeijer, J. Annelie
AU - Warps, Anne-Loes
AU - van der Woude, Lisa
AU - Detering, Robin
AU - Wolfhagen, Nienke
N1 - Funding Information: The authors would like to thank all surgeons, administrative nurses and other administrative collaborators for data registration in the DICA quality registries database, as well as all Clinical Audit Boards for their scientific input. Collaborators: Daan M. Voeten, J. Annelie Suurmeijer, Anne-Loes Warps, Lisa van der Woude, Robin Detering, Nienke Wolfhagen. Publisher Copyright: © 2022, The Author(s).
PY - 2022/10
Y1 - 2022/10
N2 - Introduction: Aging of the worldwide population has been observed, and postoperative outcomes could be worse in elderly patients. This nationwide study assessed trends in number of surgical resections in octogenarians regarding various major surgical procedures and associated postoperative outcomes. Methods: All patients who underwent surgery between 2014 and 2018 were included from Dutch nationwide quality registries regarding esophageal, stomach, pancreas, colorectal liver metastases, colorectal cancer, lung cancer and abdominal aortic aneurysms (AAA). For each quality registry, the number of patients who were 80 years or older (octogenarians) was calculated per year. Postoperative outcomes were length of stay (LOS), 30 day major morbidity and 30 day mortality between octogenarians and younger patients. Results: No increase in absolute number and proportion of octogenarians that underwent surgery was observed. Median LOS was higher in octogenarians who underwent surgery for colorectal cancer, colorectal liver metastases, lung cancer, pancreatic disease and esophageal cancer. 30 day major morbidity was higher in octogenarians who underwent surgery for colon cancer, esophageal cancer and elective AAA-repair. 30 day mortality was higher in octogenarians who underwent surgery for colorectal cancer, lung cancer, stomach cancer, pancreatic disease, esophageal cancer and elective AAA-repair. Median LOS decreased between 2014 and 2018 in octogenarians who underwent surgery for stomach cancer and colorectal cancer. 30 day major morbidity decreased between 2014 and 2018 in octogenarians who underwent surgery for colon cancer. No trends were observed in octogenarians regarding 30 day mortality between 2014 and 2018. Conclusion: No increase over time in absolute number and proportion of octogenarians that underwent major surgery was observed in the Netherlands. Postoperative outcomes were worse in octogenarians.
AB - Introduction: Aging of the worldwide population has been observed, and postoperative outcomes could be worse in elderly patients. This nationwide study assessed trends in number of surgical resections in octogenarians regarding various major surgical procedures and associated postoperative outcomes. Methods: All patients who underwent surgery between 2014 and 2018 were included from Dutch nationwide quality registries regarding esophageal, stomach, pancreas, colorectal liver metastases, colorectal cancer, lung cancer and abdominal aortic aneurysms (AAA). For each quality registry, the number of patients who were 80 years or older (octogenarians) was calculated per year. Postoperative outcomes were length of stay (LOS), 30 day major morbidity and 30 day mortality between octogenarians and younger patients. Results: No increase in absolute number and proportion of octogenarians that underwent surgery was observed. Median LOS was higher in octogenarians who underwent surgery for colorectal cancer, colorectal liver metastases, lung cancer, pancreatic disease and esophageal cancer. 30 day major morbidity was higher in octogenarians who underwent surgery for colon cancer, esophageal cancer and elective AAA-repair. 30 day mortality was higher in octogenarians who underwent surgery for colorectal cancer, lung cancer, stomach cancer, pancreatic disease, esophageal cancer and elective AAA-repair. Median LOS decreased between 2014 and 2018 in octogenarians who underwent surgery for stomach cancer and colorectal cancer. 30 day major morbidity decreased between 2014 and 2018 in octogenarians who underwent surgery for colon cancer. No trends were observed in octogenarians regarding 30 day mortality between 2014 and 2018. Conclusion: No increase over time in absolute number and proportion of octogenarians that underwent major surgery was observed in the Netherlands. Postoperative outcomes were worse in octogenarians.
UR - http://www.scopus.com/inward/record.url?scp=85135560556&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00268-022-06642-6
DO - https://doi.org/10.1007/s00268-022-06642-6
M3 - Article
C2 - 35927369
SN - 0364-2313
VL - 46
SP - 2399
EP - 2408
JO - World journal of surgery
JF - World journal of surgery
IS - 10
ER -