Abdomen agudo en el adulto mayor

Background: Nearly 10% of emergency consultations are due to acute abdominal pain. In people over 65 years old, it can have atypical presentations, that retard the correct diagnosis and worsens prognosis. Aim: To study the causes, evolution and prognosis of acute abdomen in the elderly. Material and...

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Autores principales:	Espinoza G,Ricardo, Balbontín M,Paulina, Feuerhake L,Sebastián, Piñera M,Cecilia
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Materias:	Abdomen acute Aged Surgical procedures operative
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004001200008
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spelling	oai:scielo:S0034-988720040012000082006-03-21Abdomen agudo en el adulto mayorEspinoza G,RicardoBalbontín M,PaulinaFeuerhake L,SebastiánPiñera M,Cecilia Abdomen acute Aged Surgical procedures operative Background: Nearly 10% of emergency consultations are due to acute abdominal pain. In people over 65 years old, it can have atypical presentations, that retard the correct diagnosis and worsens prognosis. Aim: To study the causes, evolution and prognosis of acute abdomen in the elderly. Material and methods: Prospective study of 45 patients aged more than 65 years old (mean age ± SD, 75.7±7.7, 51% men) and 221 patients of less than 65 years old (mean age ± SD, 36.7±14.0, 48% men), consulting for acute abdomen in the emergency room. Results: Sixty six percent of elderly patients had concomitant diseases, that were multiple in 63%. In this age group, the causes accounting for 71% of acute abdominal pain were bilio-pancreatic diseases (31.1%), intestinal adhesive obstruction (17.7%), complicated abdominal wall hernia (13.7%), and complications of peptic ulcer disease (8.9%). Sixty four percent required surgical treatment and, in almost 50% the surgical risk was classified in ASA III or IV, according to the American Society of Anesthesiology. Thirty one percent had postoperative complications. Compared with their younger counterparts, elderly patients required significantly (p<0.05) more admissions to intensive care units (2.7 and 24.2% respectively), more connections to mechanical ventilation (1.4 and 8.9% respectively) and longer hospital stays (5.4±7.4 and 12.4±10.9 days, respectively). In this series overall mortality was 6.7%, being 0.6% for young patients and 11.1% for the surgical group over 65 years old. Conclusions: Acute abdomen in the elderly has a high rate of complications and mortality. According to the causes of acute abdomen in this group, evaluation in the emergency setting with an ultrasonography may be very useful. In the elderly, elective correction of potential causes of acute abdomen should be done (Rev Méd Chile 2004; 132: 1505-12)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.12 20042004-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004001200008es10.4067/S0034-98872004001200008
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Abdomen acute Aged Surgical procedures operative
spellingShingle	Abdomen acute Aged Surgical procedures operative Espinoza G,Ricardo Balbontín M,Paulina Feuerhake L,Sebastián Piñera M,Cecilia Abdomen agudo en el adulto mayor
description	Background: Nearly 10% of emergency consultations are due to acute abdominal pain. In people over 65 years old, it can have atypical presentations, that retard the correct diagnosis and worsens prognosis. Aim: To study the causes, evolution and prognosis of acute abdomen in the elderly. Material and methods: Prospective study of 45 patients aged more than 65 years old (mean age ± SD, 75.7±7.7, 51% men) and 221 patients of less than 65 years old (mean age ± SD, 36.7±14.0, 48% men), consulting for acute abdomen in the emergency room. Results: Sixty six percent of elderly patients had concomitant diseases, that were multiple in 63%. In this age group, the causes accounting for 71% of acute abdominal pain were bilio-pancreatic diseases (31.1%), intestinal adhesive obstruction (17.7%), complicated abdominal wall hernia (13.7%), and complications of peptic ulcer disease (8.9%). Sixty four percent required surgical treatment and, in almost 50% the surgical risk was classified in ASA III or IV, according to the American Society of Anesthesiology. Thirty one percent had postoperative complications. Compared with their younger counterparts, elderly patients required significantly (p<0.05) more admissions to intensive care units (2.7 and 24.2% respectively), more connections to mechanical ventilation (1.4 and 8.9% respectively) and longer hospital stays (5.4±7.4 and 12.4±10.9 days, respectively). In this series overall mortality was 6.7%, being 0.6% for young patients and 11.1% for the surgical group over 65 years old. Conclusions: Acute abdomen in the elderly has a high rate of complications and mortality. According to the causes of acute abdomen in this group, evaluation in the emergency setting with an ultrasonography may be very useful. In the elderly, elective correction of potential causes of acute abdomen should be done (Rev Méd Chile 2004; 132: 1505-12)
author	Espinoza G,Ricardo Balbontín M,Paulina Feuerhake L,Sebastián Piñera M,Cecilia
author_facet	Espinoza G,Ricardo Balbontín M,Paulina Feuerhake L,Sebastián Piñera M,Cecilia
author_sort	Espinoza G,Ricardo
title	Abdomen agudo en el adulto mayor
title_short	Abdomen agudo en el adulto mayor
title_full	Abdomen agudo en el adulto mayor
title_fullStr	Abdomen agudo en el adulto mayor
title_full_unstemmed	Abdomen agudo en el adulto mayor
title_sort	abdomen agudo en el adulto mayor
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004001200008
work_keys_str_mv	AT espinozagricardo abdomenagudoeneladultomayor AT balbontinmpaulina abdomenagudoeneladultomayor AT feuerhakelsebastian abdomenagudoeneladultomayor AT pineramcecilia abdomenagudoeneladultomayor
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Abdomen agudo en el adulto mayor

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