Prognostic factors for morbidity and mortality in elderly patients undergoing acute gastrointestinal surgery: a systematic review.

摘要: Elderly patients (age ≥ 65) are the fastest growing subset of population in industrialized countries.1,2 This has had an impact on health care system as proportion discharged older than 65 increased from 10% 1970 to 37% 2007.3,4 trend will likely continue, 25% North Americans expected be by 2040.5 changing demographic delivery care, including surgical many ways.6 Of particular concern field general surgery is that 40% gastrointestinal (GI) surgeries elderly occurs acute (urgent or emergent) basis.7 Nonelective adults associated with a 10- 15-fold increase morbidity and 3- 5-fold mortality compared elective this age group.8–11 Furthermore, nonelective cohort also (28% v. 10%) (15.2% 2.5%) younger cohorts1,2,12 high potential for poor outcomes implications patient autonomy well cost resource planning. Prognostic factors perioperative useful clinicians several ways.3,4,13 At most basic level, prognostic can inform convey probability risks their families. Once identified, adverse potentially modified. Finally, used development risk prediction models order more accurately assess individual patients. To our knowledge, no previous review articles have explored population. With these views mind, purpose study was systematically synthesize available evidence undergoing GI surgery.