A 15-year retrospective analysis of the epidemiology and outcomes for elderly emergency general surgical admissions in the North East of England: A case for multidisciplinary geriatric input

International Journal of Surgery
Ross C McLeanPaul O'Loughlin

Abstract

Life expectancies in the UK are increasing and with this there is an increasing elderly population with more complex co-morbidity. Emergency surgery in the elderly is challenging in terms of decision making, managing co-morbidity and post-operative rehabilitation with high morbidity and mortality. To optimise service design and development, it is important to understand the changing pattern of emergency surgical care for this group. After obtaining necessary approvals, we approached each hospital trust in the North of England for details of every emergency admission under a general surgeon from 2000 to 2014. Data for each admission included demographics, co-morbidities, diagnoses, procedures undertaken and outcomes. There were 105 002 elderly (≥70 years) emergency general surgical admissions, and mean age and co-morbidity (defined by Charlson index scores) increased (both p < 0.001). Operative intervention was undertaken in a similar proportion of patients in all age groups (13%), with more patients undergoing operations over time (p < 0.001), of which 50% were within 48 h of admission. Overall in-hospital mortality decreased significantly as did length of hospital stay (both p < 0.001). Factors associated with increased 30 day...Continue Reading

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Citations

Feb 1, 2018·Updates in Surgery·Gianluca CostaUNKNOWN ERASO (Elderly Risk Assessment for Surgical Outcome) Collaborative Study Group
Apr 17, 2018·The British Journal of Surgery·T E PoultonS R Moonesinghe
Feb 20, 2018·ANZ Journal of Surgery·Lauren StyanMartin Wullschleger
Jun 19, 2018·Annals of the Royal College of Surgeons of England·A Vilches-MoragaL Pearce
Aug 5, 2017·Annals of the Royal College of Surgeons of England·Wte BriggsS M McDonnell
Feb 24, 2020·Updates in Surgery·Gianluca CostaUNKNOWN ERASO (Elderly Risk Assessment and Surgical Outcome) Collaborative Study Group
Jan 28, 2021·The Journal of Trauma and Acute Care Surgery·Matthew P GuttmanBarbara Haas

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