Effect of emergency general surgery on postoperative performance status in patients aged over 90 years
Background: Functional deterioration following emergency general surgery (EGS) poses a significant challenge in super-elderly patients. However, limited research has focused on assessing the deterioration in postoperative performance status (PS). This study aimed to investigate the impact of EGS on...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Surgery Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845023000787 |
| _version_ | 1797338222848638976 |
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| author | Kaichiro Harada Kenya Yamanaka Makoto Kurimoto Hikaru Aoki Akina Shinkura Yusuke Hanabata Masashi Kayano Misaki Tashima Jun Tamura |
| author_facet | Kaichiro Harada Kenya Yamanaka Makoto Kurimoto Hikaru Aoki Akina Shinkura Yusuke Hanabata Masashi Kayano Misaki Tashima Jun Tamura |
| author_sort | Kaichiro Harada |
| collection | DOAJ |
| description | Background: Functional deterioration following emergency general surgery (EGS) poses a significant challenge in super-elderly patients. However, limited research has focused on assessing the deterioration in postoperative performance status (PS). This study aimed to investigate the impact of EGS on PS deterioration in super-elderly patients, and the extent to which deteriorated PS is recovered. Methods: This historical cohort study comprised 77 super-elderly patients who underwent EGS between July 2015 and December 2020. Functional deterioration was evaluated by comparing preoperative and postoperative Eastern Cooperative Oncology Group Performance Status (ECOG-PS). The Emergency Surgical Score (ESS) was used as a risk-adjustment tool. Questionnaires were mailed to the patients and their families to assess post-discharge PS and obtain their impressions of EGS. Results: Postoperative PS deteriorated in 35/77 patients (45.5 %). Significant differences were observed between the groups in terms of sex, serum C-reactive protein (CRP) levels, ESS scores, preoperative ECOG-PS, duration of operation, and major complications. Multivariate analysis of preoperative factors showed that ESS ≥7 (OR: 3.7, 95 % CI: 1.0–13), preoperative ECOG-PS ≤2 (OR: 5.9, 95 % CI: 1.7–21), and female sex (OR: 5.8, 95 % CI: 1.6–21) were associated with postoperative ECOG-PS deterioration. According to the questionnaire results, PS recovery post-discharge was observed in 6/36 (17 %) patients, and 34/36 (94 %) patients and their families expressed positive impressions of EGS. Conclusions: EGS in super-elderly patients highly caused a deterioration in their PS, particularly in patients with maintained preoperative PS. PS hardly recovered; however, most patients and their families had positive impressions of the EGS. Key message: We assessed the pre- and postoperative performance status of super-elderly patients who underwent emergency general surgery. Surgery caused a marked deterioration in patients' functional performance, which seldom recovered postoperatively. |
| first_indexed | 2024-03-08T09:27:54Z |
| format | Article |
| id | doaj.art-76635cab34104470a876299adc736219 |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-03-08T09:27:54Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-76635cab34104470a876299adc7362192024-01-31T05:45:23ZengElsevierSurgery Open Science2589-84502024-01-011715Effect of emergency general surgery on postoperative performance status in patients aged over 90 yearsKaichiro Harada0Kenya Yamanaka1Makoto Kurimoto2Hikaru Aoki3Akina Shinkura4Yusuke Hanabata5Masashi Kayano6Misaki Tashima7Jun Tamura8Department of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanCorresponding author.; Department of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanDepartment of Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa, Amagasaki, Hyogo, JapanBackground: Functional deterioration following emergency general surgery (EGS) poses a significant challenge in super-elderly patients. However, limited research has focused on assessing the deterioration in postoperative performance status (PS). This study aimed to investigate the impact of EGS on PS deterioration in super-elderly patients, and the extent to which deteriorated PS is recovered. Methods: This historical cohort study comprised 77 super-elderly patients who underwent EGS between July 2015 and December 2020. Functional deterioration was evaluated by comparing preoperative and postoperative Eastern Cooperative Oncology Group Performance Status (ECOG-PS). The Emergency Surgical Score (ESS) was used as a risk-adjustment tool. Questionnaires were mailed to the patients and their families to assess post-discharge PS and obtain their impressions of EGS. Results: Postoperative PS deteriorated in 35/77 patients (45.5 %). Significant differences were observed between the groups in terms of sex, serum C-reactive protein (CRP) levels, ESS scores, preoperative ECOG-PS, duration of operation, and major complications. Multivariate analysis of preoperative factors showed that ESS ≥7 (OR: 3.7, 95 % CI: 1.0–13), preoperative ECOG-PS ≤2 (OR: 5.9, 95 % CI: 1.7–21), and female sex (OR: 5.8, 95 % CI: 1.6–21) were associated with postoperative ECOG-PS deterioration. According to the questionnaire results, PS recovery post-discharge was observed in 6/36 (17 %) patients, and 34/36 (94 %) patients and their families expressed positive impressions of EGS. Conclusions: EGS in super-elderly patients highly caused a deterioration in their PS, particularly in patients with maintained preoperative PS. PS hardly recovered; however, most patients and their families had positive impressions of the EGS. Key message: We assessed the pre- and postoperative performance status of super-elderly patients who underwent emergency general surgery. Surgery caused a marked deterioration in patients' functional performance, which seldom recovered postoperatively.http://www.sciencedirect.com/science/article/pii/S2589845023000787Emergency general surgerySuper-elderlyEastern cooperative oncology group-performance statusEmergency surgical score |
| spellingShingle | Kaichiro Harada Kenya Yamanaka Makoto Kurimoto Hikaru Aoki Akina Shinkura Yusuke Hanabata Masashi Kayano Misaki Tashima Jun Tamura Effect of emergency general surgery on postoperative performance status in patients aged over 90 years Surgery Open Science Emergency general surgery Super-elderly Eastern cooperative oncology group-performance status Emergency surgical score |
| title | Effect of emergency general surgery on postoperative performance status in patients aged over 90 years |
| title_full | Effect of emergency general surgery on postoperative performance status in patients aged over 90 years |
| title_fullStr | Effect of emergency general surgery on postoperative performance status in patients aged over 90 years |
| title_full_unstemmed | Effect of emergency general surgery on postoperative performance status in patients aged over 90 years |
| title_short | Effect of emergency general surgery on postoperative performance status in patients aged over 90 years |
| title_sort | effect of emergency general surgery on postoperative performance status in patients aged over 90 years |
| topic | Emergency general surgery Super-elderly Eastern cooperative oncology group-performance status Emergency surgical score |
| url | http://www.sciencedirect.com/science/article/pii/S2589845023000787 |
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