Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention
Objective: We aimed to identify preoperative and intraoperative factors associated with serious postoperative outcomes, which may help patients and clinicians make better-informed decisions. Methods: We conducted a retrospective study including all patients aged ≥90 years who underwent surgery betwe...
| Main Authors: | , , , , , |
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| Language: | English |
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Elsevier
2023-02-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023003249 |
| _version_ | 1811161880119476224 |
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| author | Hong Fu Jiang Zheng Jingyi Lai Victor W. Xia Kaiping He Dingyuan Du |
| author_facet | Hong Fu Jiang Zheng Jingyi Lai Victor W. Xia Kaiping He Dingyuan Du |
| author_sort | Hong Fu |
| collection | DOAJ |
| description | Objective: We aimed to identify preoperative and intraoperative factors associated with serious postoperative outcomes, which may help patients and clinicians make better-informed decisions. Methods: We conducted a retrospective study including all patients aged ≥90 years who underwent surgery between January 1, 2011, and January 1, 2021, at Chongqing University Central Hospital. We assessed 30 pre- and intraoperative demographic and clinical variables. Logistic regression was used to identify the independent risk factors for serious postoperative outcomes in patients aged ≥90 years. Results: A total of 428 patients were included in our analysis. The mean age was 92.6 years (SD ± 2.6). There were 240 (56.1%) females and 188 (43.9%) males. The most common comorbidities were hypertension (44.9%) and arrhythmias (34.8%). The 30-day hospital mortality was 5.6%, and severe morbidity was 33.2%. Based on the multivariate logistic regression classification analysis of the American Society of Anesthesiologists (ASA)≥ Ⅳ [odds ratio (OR), 5.39, 95% confidence interval (CI), 2.06–14.16, P = .001], emergency surgery (OR, 5.02, 95% CI, 2.85–15.98, P = .001) and chronic heart failure (OR, 6.11, 95% CI, 1.93–13.06, P = .001) were identified as independent risk factors for 30-day hospital mortality, and ASA≥ Ⅳ (OR, 4.56, 95%CI, 2.56–8.15, P < .001), Barthel index (BI) < 35 (OR, 2.28, 95%CI, 1.30–3.98, P = .001), chronic heart failure (OR, 3.67, 95%CI, 1.62–8.31, P = .002), chronic kidney disease (OR, 4.24, 95%CI, 1.99–9.05, P < .001), general anesthesia (OR, 3.31, 95%CI, 1.91–5.76, P < .001), emergency surgery (OR, 3.72, 95%CI, 1.98–6.99, P < .001), and major surgery (OR, 3.44, 95%CI, 1.90–6.22, P < .001) were identified as independent risk factors for serious postoperative complications. Conclusions: Patients aged ≥90 years with ASA≥ Ⅳ, BI < 35, combined with chronic heart failure or chronic kidney disease, undergoing emergency surgery, major surgery or general anesthesia have a higher risk of serious postoperative outcomes. Identifying these risk factors in an early stage may contribute to our clinical decision-making and improve the quality of treatments. |
| first_indexed | 2024-04-10T06:21:08Z |
| format | Article |
| id | doaj.art-e925af7d9134407ca6d6484522f4e4b3 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-10T06:21:08Z |
| publishDate | 2023-02-01 |
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| spelling | doaj.art-e925af7d9134407ca6d6484522f4e4b32023-03-02T05:00:07ZengElsevierHeliyon2405-84402023-02-0192e13117Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical interventionHong Fu0Jiang Zheng1Jingyi Lai2Victor W. Xia3Kaiping He4Dingyuan Du5Department of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, China; Corresponding author. Department of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, No 1, JianKang Road, Yuzhong District, Chongqing 400014, China.Department of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, ChinaDepartment of Anesthesiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, ChinaDepartment of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, USA; David Geffen School of Medicine at UCLA, Los Angeles, USADivision of Medical Record Statistical, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, ChinaDepartment of Traumatology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, China; Corresponding author. Department of traumatology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China.Objective: We aimed to identify preoperative and intraoperative factors associated with serious postoperative outcomes, which may help patients and clinicians make better-informed decisions. Methods: We conducted a retrospective study including all patients aged ≥90 years who underwent surgery between January 1, 2011, and January 1, 2021, at Chongqing University Central Hospital. We assessed 30 pre- and intraoperative demographic and clinical variables. Logistic regression was used to identify the independent risk factors for serious postoperative outcomes in patients aged ≥90 years. Results: A total of 428 patients were included in our analysis. The mean age was 92.6 years (SD ± 2.6). There were 240 (56.1%) females and 188 (43.9%) males. The most common comorbidities were hypertension (44.9%) and arrhythmias (34.8%). The 30-day hospital mortality was 5.6%, and severe morbidity was 33.2%. Based on the multivariate logistic regression classification analysis of the American Society of Anesthesiologists (ASA)≥ Ⅳ [odds ratio (OR), 5.39, 95% confidence interval (CI), 2.06–14.16, P = .001], emergency surgery (OR, 5.02, 95% CI, 2.85–15.98, P = .001) and chronic heart failure (OR, 6.11, 95% CI, 1.93–13.06, P = .001) were identified as independent risk factors for 30-day hospital mortality, and ASA≥ Ⅳ (OR, 4.56, 95%CI, 2.56–8.15, P < .001), Barthel index (BI) < 35 (OR, 2.28, 95%CI, 1.30–3.98, P = .001), chronic heart failure (OR, 3.67, 95%CI, 1.62–8.31, P = .002), chronic kidney disease (OR, 4.24, 95%CI, 1.99–9.05, P < .001), general anesthesia (OR, 3.31, 95%CI, 1.91–5.76, P < .001), emergency surgery (OR, 3.72, 95%CI, 1.98–6.99, P < .001), and major surgery (OR, 3.44, 95%CI, 1.90–6.22, P < .001) were identified as independent risk factors for serious postoperative complications. Conclusions: Patients aged ≥90 years with ASA≥ Ⅳ, BI < 35, combined with chronic heart failure or chronic kidney disease, undergoing emergency surgery, major surgery or general anesthesia have a higher risk of serious postoperative outcomes. Identifying these risk factors in an early stage may contribute to our clinical decision-making and improve the quality of treatments.http://www.sciencedirect.com/science/article/pii/S2405844023003249Aged ≥90 yearsSurgeryRisk factorSerious postoperative outcome |
| spellingShingle | Hong Fu Jiang Zheng Jingyi Lai Victor W. Xia Kaiping He Dingyuan Du Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention Heliyon Aged ≥90 years Surgery Risk factor Serious postoperative outcome |
| title | Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention |
| title_full | Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention |
| title_fullStr | Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention |
| title_full_unstemmed | Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention |
| title_short | Risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention |
| title_sort | risk factors of serious postoperative outcomes in patients aged ≥90 years undergoing surgical intervention |
| topic | Aged ≥90 years Surgery Risk factor Serious postoperative outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023003249 |
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