TY - JOUR
T1 - Safety of Endoscopic Sinus Surgery in the Elderly—Are Octogenarian Patients at a Higher Risk?
AU - Levi, Lirit
AU - Reuven, Yonatan
AU - Ben-Ner, Daniel
AU - Koch, Noam
AU - Gunders-Peleg, Mor
AU - Nachalon, Yuval
AU - Koren, Ilan
AU - Hazan, Alain
AU - Nakache, Gabriel
AU - Reifen, Ella
AU - Soudry, Ethan
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2022/1
Y1 - 2022/1
N2 - Background: Surgeons are often faced with concerns regarding the risks versus benefits of endoscopic sinus surgery (ESS) in elderly patients. Objective: To analyze the risk for complications of ESS in the elderly (age ≥70 years) compared to younger patients, with emphasis on octogenarians. Methods: Retrospective review of medical charts of adult patients who underwent ESS at a tertiary referral center during the years 2014 to 2018. Results: We compared 128 elderly patients with 276 matched younger patients. In the elderly group mean age was 76 years (range, 70-91 years). Thirty-one elderly patients were 80 years or older. Surgical complications in the elderly patients were 3.9%. Minor complications were 2.3% and major complications were 1.7%. The surgical complications rate was similar in the younger group (8%, P value:.127). Medical complications were observed in 2.3% comparing to 0.7% in younger patients. Interestingly, age, revision surgery, extent and duration of surgery, and modality of anesthesia were not identified as risk factors. Only ischemic heart disease (IHD) was identified as a risk factor for complications in a multivariate analysis in elderly patients. Comparison of elderly patients younger than 80 years with octogenarians revealed no difference in complication rate between these groups. Conclusions: Overall, ESS was found to be a safe procedure in elderly patients compared to younger patients. Octogenarian patients should not be denied upfront surgery. IHD is a risk factor for complications in elderly patients.
AB - Background: Surgeons are often faced with concerns regarding the risks versus benefits of endoscopic sinus surgery (ESS) in elderly patients. Objective: To analyze the risk for complications of ESS in the elderly (age ≥70 years) compared to younger patients, with emphasis on octogenarians. Methods: Retrospective review of medical charts of adult patients who underwent ESS at a tertiary referral center during the years 2014 to 2018. Results: We compared 128 elderly patients with 276 matched younger patients. In the elderly group mean age was 76 years (range, 70-91 years). Thirty-one elderly patients were 80 years or older. Surgical complications in the elderly patients were 3.9%. Minor complications were 2.3% and major complications were 1.7%. The surgical complications rate was similar in the younger group (8%, P value:.127). Medical complications were observed in 2.3% comparing to 0.7% in younger patients. Interestingly, age, revision surgery, extent and duration of surgery, and modality of anesthesia were not identified as risk factors. Only ischemic heart disease (IHD) was identified as a risk factor for complications in a multivariate analysis in elderly patients. Comparison of elderly patients younger than 80 years with octogenarians revealed no difference in complication rate between these groups. Conclusions: Overall, ESS was found to be a safe procedure in elderly patients compared to younger patients. Octogenarian patients should not be denied upfront surgery. IHD is a risk factor for complications in elderly patients.
KW - chronic rhinosinusitis
KW - elderly
KW - endoscopic sinus surgery
KW - neoplasm
KW - octogenarians
KW - postoperative complications
UR - http://www.scopus.com/inward/record.url?scp=85109662627&partnerID=8YFLogxK
U2 - 10.1177/19458924211025374
DO - 10.1177/19458924211025374
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C2 - 34236249
AN - SCOPUS:85109662627
SN - 1945-8924
VL - 36
SP - 91
EP - 98
JO - American Journal of Rhinology and Allergy
JF - American Journal of Rhinology and Allergy
IS - 1
ER -