TY - JOUR
T1 - Short-term postoperative outcomes after liver resection in the elderly patient
T2 - a nationwide population-based study
AU - Elfrink, Arthur K. E.
AU - Kok, Niels F. M.
AU - den Dulk, Marcel
AU - Buis, Carlijn I.
AU - Kazemier, Geert
AU - Ijzermans, Jan N. M.
AU - Lam, Hwai-Ding
AU - Hagendoorn, Jeroen
AU - van den Boezem, Peter B.
AU - Ayez, Ninos
AU - Zonderhuis, Babs M.
AU - Lips, Daan J.
AU - Leclercq, Wouter K. G.
AU - Kuhlmann, Koert F. D.
AU - Marsman, Hendrik A.
AU - Verhoef, Cornelis
AU - Patijn, Gijs A.
AU - Grünhagen, Dirk J.
AU - Klaase, Joost M.
AU - Eker, Hasan H.
AU - Belt, Eric T. J.
AU - van Heek, N. Tjarda
AU - Torrenga, Hans
AU - Bosscha, Koop
AU - Doornebosch, Pascal
AU - Consten, Esther C. J.
AU - Collaborators
AU - Oosterling, Steven J.
AU - de Boer, Marieke T.
AU - Dutch Hepato Biliary Audit Group
AU - Besselink, Marc G. H.
AU - Dejong, Cornelis H. C.
AU - te Riele, Wouter W.
AU - Hoogwater, Frederik J. H.
AU - Liem, Mike S. L.
AU - Molenaar, I. Quintus
AU - Swijnenburg, Rutger-Jan
AU - Braat, Andries E.
N1 - Funding Information: The authors would like to thank all surgeons, interventional radiologists and administrative nurses for data registration in the DHBA database, as well as the Dutch Hepato Biliary Audit Group for scientific input. Publisher Copyright: © 2021 The Author(s)
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: Liver resection is high-risk surgery in particular in elderly patients. The aim of this study was to explore postoperative outcomes after liver resection in elderly patients. Methods: In this nationwide study, all patients who underwent liver resection for primary and secondary liver tumours in the Netherlands between 2014 and 2019 were included. Age groups were composed as younger than 70 (70-), between 70 and 80 (septuagenarians), and 80 years or older (octogenarians). Proportion of liver resections per age group and 30-day major morbidity and 30-day mortality were assessed. Results: In total, 6587 patients were included of whom 4023 (58.9%) were younger than 70, 2135 (32.4%) were septuagenarians and 429 (6.5%) were octogenarians. The proportion of septuagenarians increased during the study period (aOR:1.06, CI:1.02–1.09, p < 0.001). Thirty-day major morbidity was higher in septuagenarians (11%) and octogenarians (12%) compared to younger patients (9%, p = 0.049). Thirty-day mortality was higher in septuagenarians (4%) and octogenarians (4%) compared to younger patients (2%, p < 0.001). Cardiopulmonary complications occurred more frequently with higher age, liver-specific complications did not. Higher age was associated with higher 30-day morbidity and 30-day mortality in multivariable logistic regression. Conclusion: Thirty-day major morbidity and 30-day mortality are higher after liver resection in elderly patients, attributed mainly to non-surgical cardiopulmonary complications.
AB - Background: Liver resection is high-risk surgery in particular in elderly patients. The aim of this study was to explore postoperative outcomes after liver resection in elderly patients. Methods: In this nationwide study, all patients who underwent liver resection for primary and secondary liver tumours in the Netherlands between 2014 and 2019 were included. Age groups were composed as younger than 70 (70-), between 70 and 80 (septuagenarians), and 80 years or older (octogenarians). Proportion of liver resections per age group and 30-day major morbidity and 30-day mortality were assessed. Results: In total, 6587 patients were included of whom 4023 (58.9%) were younger than 70, 2135 (32.4%) were septuagenarians and 429 (6.5%) were octogenarians. The proportion of septuagenarians increased during the study period (aOR:1.06, CI:1.02–1.09, p < 0.001). Thirty-day major morbidity was higher in septuagenarians (11%) and octogenarians (12%) compared to younger patients (9%, p = 0.049). Thirty-day mortality was higher in septuagenarians (4%) and octogenarians (4%) compared to younger patients (2%, p < 0.001). Cardiopulmonary complications occurred more frequently with higher age, liver-specific complications did not. Higher age was associated with higher 30-day morbidity and 30-day mortality in multivariable logistic regression. Conclusion: Thirty-day major morbidity and 30-day mortality are higher after liver resection in elderly patients, attributed mainly to non-surgical cardiopulmonary complications.
UR - http://www.scopus.com/inward/record.url?scp=85107621535&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hpb.2021.03.002
DO - https://doi.org/10.1016/j.hpb.2021.03.002
M3 - Article
C2 - 33926842
SN - 1365-182X
VL - 23
SP - 1506
EP - 1517
JO - HPB
JF - HPB
IS - 10
ER -