Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery

Introduction and objective: Perioperative management of elderly (aged 65 or older) surgical patients has become an essential component of surgical and anesthetic practice. Certain preoperative and intraoperative factors may predict adverse outcomes in such patients. The objective was to determine t...

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Autor principal:	Pralaya Khadka
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	geriatric outcomes predictors surgery Surgery RD1-811
Acceso en línea:	https://doaj.org/article/655b9afe22c942a98de7ee6d21d1222e
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spelling	oai:doaj.org-article:655b9afe22c942a98de7ee6d21d1222e2021-12-05T19:16:41ZImportance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery10.3126/jssn.v18i3.152871815-39842392-4772https://doaj.org/article/655b9afe22c942a98de7ee6d21d1222e2016-07-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/15287https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction and objective: Perioperative management of elderly (aged 65 or older) surgical patients has become an essential component of surgical and anesthetic practice. Certain preoperative and intraoperative factors may predict adverse outcomes in such patients. The objective was to determine the prevalence and predictors of adverse postoperative outcomes in older surgical patients undergoing major gastrointestinal surgery. Materials and Methods: Prospective study of consecutive elderly patients who underwent major gastrointestinal surgery between August 2015 and November 2015 in Tribhuwan University Teaching Hospital. Patients were followed up to 1 month after surgery. Potential pre- and intra-operative risk factors were measured and evaluated for their association with the occurrence of predefined adverse outcomes. Multivariate logistic regression of predictors of postoperative outcomes were measured. Odds ratios (OR) with 95% confidence interval (CI) and two-sided p-values were reported. Results: One hundred and thirty-three consecutive patients were studied. Overall, 89 (66.9%) of patients developed one or more postoperative adverse outcomes and 6 (4.51%) died during their postoperative period. Of all the adverse outcomes, Respiratory (38.3%) were the leading cause of morbidity, followed by Gastrointestinal (32.3%) and Cardiovascular (28.8%) complications. By multivariate logistic regression analysis, presence of comorbidites (OR 1.8, CI 1.1-2.8), low albumin (OR 2.71, CI 0.1-6.6), tachycardia (OR 3.7, CI 1.2-10.8) and hypotension (OR 8.9, CI 1.1-17) were the significant predictors of postoperative adverse outcomes. The mean hospital stay was 7.4±3.8 days. Conclusion: Low albumin and presence of comorbidities, tachycardia and hypotension are significant predictors of adverse surgical outcomes. Age by itself is not associated with adverse outcomes. Pralaya KhadkaSociety of Surgeons of NepalarticlegeriatricoutcomespredictorssurgerySurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	geriatric outcomes predictors surgery Surgery RD1-811
spellingShingle	geriatric outcomes predictors surgery Surgery RD1-811 Pralaya Khadka Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
description	Introduction and objective: Perioperative management of elderly (aged 65 or older) surgical patients has become an essential component of surgical and anesthetic practice. Certain preoperative and intraoperative factors may predict adverse outcomes in such patients. The objective was to determine the prevalence and predictors of adverse postoperative outcomes in older surgical patients undergoing major gastrointestinal surgery. Materials and Methods: Prospective study of consecutive elderly patients who underwent major gastrointestinal surgery between August 2015 and November 2015 in Tribhuwan University Teaching Hospital. Patients were followed up to 1 month after surgery. Potential pre- and intra-operative risk factors were measured and evaluated for their association with the occurrence of predefined adverse outcomes. Multivariate logistic regression of predictors of postoperative outcomes were measured. Odds ratios (OR) with 95% confidence interval (CI) and two-sided p-values were reported. Results: One hundred and thirty-three consecutive patients were studied. Overall, 89 (66.9%) of patients developed one or more postoperative adverse outcomes and 6 (4.51%) died during their postoperative period. Of all the adverse outcomes, Respiratory (38.3%) were the leading cause of morbidity, followed by Gastrointestinal (32.3%) and Cardiovascular (28.8%) complications. By multivariate logistic regression analysis, presence of comorbidites (OR 1.8, CI 1.1-2.8), low albumin (OR 2.71, CI 0.1-6.6), tachycardia (OR 3.7, CI 1.2-10.8) and hypotension (OR 8.9, CI 1.1-17) were the significant predictors of postoperative adverse outcomes. The mean hospital stay was 7.4±3.8 days. Conclusion: Low albumin and presence of comorbidities, tachycardia and hypotension are significant predictors of adverse surgical outcomes. Age by itself is not associated with adverse outcomes.
format	article
author	Pralaya Khadka
author_facet	Pralaya Khadka
author_sort	Pralaya Khadka
title	Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
title_short	Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
title_full	Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
title_fullStr	Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
title_full_unstemmed	Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
title_sort	importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/655b9afe22c942a98de7ee6d21d1222e
work_keys_str_mv	AT pralayakhadka importanceofpreoperativehealthstatusandintraoperativefactorsinpredictingadverseoutcomesingeriatricpatientsundergoingmajorgastrointestinalsurgery
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Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery

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