Surgery in the aged

Of 503 abdominal operations performed on patients aged 75 years or more emergency surgery was performed in 196 with a mortality of 32%; semiurgent surgery in 192 with a mortality of 23%; and elective surgery in 115 with a mortality of 3%. Overall mortality was 109 cases. About half of these died because of their original disease. Of 168 operated on because of malignant diseases, 48 died (28.5%), and of 335 patients operated on because of benign diseases, 62 died (18.5%). The most frequent post-operative complications were septicemia and uremia. Arteriosclerotic heart diseases and diabetes had only a slight influence on the post operative mortality, while the presence of uremia prior to surgery was a bad prognostic sign. The age of the patient per se does not constitute a contraindication for surgery. Elderly patients should undergo elective rather than urgent surgery, provided that this approach does not endanger the patient's life. Pre- and post-operative care should be meticulous in order to improve the results of surgical treatment in the elderly.