Clinical Characteristics of the Geriatric Surgical Patients

ABSTRACT

BACKGROUND: Due to rapid economic growth and the development of medical science, the human life span is increasing nowadays. Due to this, old-aged people are increasing in number. However, the physiologic reserve power of old-aged people is lower than that of younger people. Therefore, it is necessary to be very careful about peri-operative care when doing surgery on old-aged people under general or spinal anesthesia. METHODS: We analyzed the medical records of 460 patients over 65 years of age who had undergone operations from August 1990 to July 1996 at the Department of General Surgery, Inchon Medical Center. RESULTS: (1) The ratio of geriatric surgical patients to all surgical patients during the same period was 14.7% (460/3122). Especially, the proportion of geriatric surgical patients increased to 17.0% during the last 2 years of this study compared to 16.2% for the previous 2 years, and 10.6% for the first 2 years. (2) The age distribution was 148 patients from 65 to 69 years (32.2%), 158 patients from 70 to 74 years (34.3%), 90 patients from 75 to 79 years (19.6%), and 64 patients over 80 years (13.9%). There was no significant difference between the number of men and women, there being 232 men and 228 women. (3) Among the 464 cases, 99 cases (21.3%) were malignant diseases compared to 365 cases (78.7%) of benign disease. Stomach cancer was the most common, 36 cases, colon cancer accounted for 31 cases and hepatobiliary cancer for 12 cases. Of the benign diseases, 103 cases (28.2%) were acute appendicitis, 85 (23.4%) were hepatobiliary diseases, 73 (20.1%) were hernias, and 35 (9.6%) were anal diseases. (4) Two hundred twenty-two (222) preoperative-associated diseases were found in 460 patients (48.3%). Cardiovascular disease was the most common (17.4%), and pulmonary disease was the 2nd most common (15.9%). (5) Of the total 133 cases of postoperative complication occurrence, wound infection was the most common, 43 cases, followed by pneumonia, 30 cases, respiratory failure, 11 cases, and renal failure, 7 cases. (6) The postoperative mortality rate was 5.0% and the most common cause was respiratory failure, 8 cases, followed by sepsis, 8 cases. CONCLUSION: The field of geriatric surgery must be pioneered and developed more by surgeons because the number of geriatric surgical patients is increasing more rapidly at present than in the past.