ACTA FAC MED NAISS 2008; 25 (4): 195-200

 

Original article

 

POSTOPERATIVE COMPLICATIONS AND MORTALITY AFTER ELECTIVE OPERATIONS FOR CANCER OF DIGESTIVE SYSTEM IN ELDERLY 

 

Milica Nestorovic 1
Goran Stanojevic 1,
Zoran Rancic 1
Miodrag Stojanovic 2
Vanja Pecic 1,
Branko Brankovic 1
Milan Radojkovic 1
Marija Dimitrijevic 1


1 Surgical Clinic, Clinical Center Nis
2 Public Health Institute, Nis

 

  SUMMARY

 

Geriatric population is rapidly growing. The incidence of cancer increases substantially with age. We investigated the risk of elective abdominal surgery for malignant tumors of the digestive system depending on age and co-morbididity.
In our prospective study, we analyzed 120 patients with malignant tumors of the digestive system, in which elective curative resections were performed. We divided the patients into three groups: the first under 64 years, the second between 65 and 74, and the third over 75 years of age. In the postoperative course we recorded different types of complications and intra-hospital mortality. Results were described in total numbers and/or frequency percents. The influence of age and number of co-morbid conditions and compli-cations on postoperative mortality was investigated by stepwise logistic regre-ssion; 44.2% of patients were younger than 64 years of age, the same number was between 65 and 74 years and 11.7% older than 75 years of age. Nearly half of the patients in the first group did not have any co-morbidity. Only 18.9% in the second group and 28.6% in the third did not have co-morbidities. The rate of postoperative complications was higher in the elderly. The rate of postoperative mortality was also higher but without statistical significance among the groups. Using stepwise logistic regression, we found that age alone or co-morbidity, irrespective of the numbers, are not independent risk factors for mortality.
Overall mortality of 8.95 % in patients older than 65 years justifies radical surgical intervention even in very old individuals without severe co-morbid conditions or functional impairment, since they could benefit from surgery in a similar degree as younger patient.

Key words: cancer surgery, elderly, postoperative complications