The evaluation of mortality in abdominal surgery of patients aged over 75. A retrospective study on a series of 111 cases

UNLABELLED: Abdominal surgery of patients aged over 75 is a real challenge, regarding the risk-benefit ratio, especially in emergency cases. The aim of the study was to assess the mortality in elderly patients admitted for abdominal surgical conditions. MATERIAL AND METHODS: A retrospective study was carried out on a series of 111 patients aged over 75 that died during hospitalization for abdominal diseases in the 3rd Surgical Unit during the period 2007-2010. Data from the medical files, operating books and pathology reports were collected and analyzed. RESULTS: Of the 61 cases admitted for benign conditions, 11 deceased prior to surgery due to high ASA risk. 50 patients underwent surgery, mainly on emergency basis (42 cases). Most of the patients in this group suffered from intestinal infarction (22), followed by abdominal sepsis (16), intestinal obstruction (12) and digestive bleeding (10). Resection followed by anastomosis was performed in 17 cases; of these, anastomotic fistula with sepsis developed in 7 cases (41%). Malignant abdominal diseases were diagnosed in 50 patients, most frequently colorectal cancer (25) followed by gastric cancer (14), pancreatic cancer (5), billiary duct carcinoma (3), malignant ampuloma (2) and hepatoma (1). In this group, 46 patients were operated on, mainly in emergency (35). Of the 32 cases where resection was performed, anastomostic fistula with sepsis developed in 21 (65,6 %). CONCLUSIONS: the main cause of death was abdominal sepsis due to anastomotic fistula following resections, for both benign and malignant condition.