Sobrevida postoperatoria en pacientes nonagenarios: Estudio pronóstico en cohorte retrospectiva 2001-2010, Clínica Dávila / Postoperative survival among nonagenarians: A retrospective study
Rev. méd. Chile
;
141(1): 34-40, ene. 2013. ilus, tab
Artículo
en Español
| LILACS
| ID: lil-674043
ABSTRACT
Background:
As the Chilean population ages, anesthesiologists are regularly faced with elderly and even nonagenarian people undergoing surgical procedures.Aim:
To determine the postoperative survival time in nonagenarians and its risk factors at a private clinic. Material andMethods:
Review of medical records of the clinic, searching for patients aged 90 years or older, which were subjected to a surgical procedure between 2001 and 2012. Certification ofsurvival or death was obtainedfrom the clinical records or death certification at the National Identification Service. Survival analysis was made using Kaplan-Meier and Gompertz regression.Results:
The medical records of167 patients, aged 90 to 101 years (64% women), were reviewed. Sixty four percent had an underlying cardiovascular disease; in 37%, cognitive impairment. Hip fracture surgery was the most common procedure. One intraoperative death occurred. Five percent ofpatients died one month after surgery. The median survival time was two years and the longest, seven years. According to Gompertz probability regression, the predictors of death were the presence of cardiac disease (Hazard ratio (HR) 1.91, 95% confidence intervals (95% CI) 1.16; 3.16), cognitive impairment (HR 2.10,95% CI 1.32; 3,22), cancer (HR2.10,95% CI 1.32; 3.22), requirement of transfusion (HR 1.79, 95% CI 1.13; 2.83) and an American Society of Anesthesiologists (ASA) Class III classification (HR 1.95, IC95% 1.21; 3.15).Conclusions:
In nonagenarian patients undergoing surgery; 50% mortality was observed 2 years after surgery. The presence of cardiac disease, cognitive impairment, cancer, transfusion and a Class IIIASA classification were predictors of death.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Transfusión Sanguínea
/
Enfermedades Cardiovasculares
/
Indicadores de Salud
/
Trastornos del Conocimiento
/
Fracturas de Cadera
/
Anestesia
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Anciano
/
Aged80
/
Femenino
/
Humanos
/
Masculino
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2013
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Clínica Dávila/CL
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