High death rates among elderly after surgery
Serious adverse events after surgery are common and resulting in high death rates among the elderly according to a study in the latest issue of the Medical Journal of Australia.
The study was conducted by the Austin and Repatriation Medical Centre in Heidelberg, Victoria and included 1125 patients who had undergone inpatient surgery at the centre between December 1998 and March 1999.
In this group, researchers found that 190 patients experienced serious adverse events (SAEs), 80 of whom died as a result.
SAEs were defined as incidents such as respiratory failure, cardiac arrest, stroke, acute renal failure or emergency admission to an intensive care unit.
They also found that the number of SAEs did not change significantly with the type of surgery performed.
Study author and Director of Intensive Care Research at the Austin and Repatriation Medical Centre, Dr Rinaldo Bellomo, said the incidence of SAEs was particularly high in patients over 75 years of age.
"Among 262 such patients…59 (22.5%) experienced an SAE, and 37 (14.1%) died. Six of nine patients over 92 years of age having hip surgery died," Dr Bellomo said.
He said the mortality rate reached 20% when the patient had the combined risk factors of being aged over 75 and having undergone unscheduled surgery.
"In our view, this is a 'silent' epidemic which requires urgent and systematic attention,"
Dr Bellomo said.
"Our study could not address the cause of the SAEs, which is likely to be extremely complex.
"Our findings suggest that there is much scope for improving perioperative care in our tertiary hospitals," he said.
The Medical Journal of Australia is a publication of the Australian Medical Association.