• Experience with 189 patients aged 70 years or older undergoing major abdominal surgery is analyzed as to factors affecting the prognosis and safeguards to be recommended.
The largest group consisted of 109 patients operated on for diseases of the colon and rectum, and the operation most frequently required in this group was intestinal resection. The commonest cause for emergency surgery in aged patients was massive gastrointestinal hemorrhage necessitating gastric resection. In the 21 patients who died, the most frequent cause of death was pulmonary embolism and the second most frequent was chronic infection. Elderly patients did not tolerate chronic infections, and emergency operations carried a much higher risk than did elective surgery, but in general neither age nor sex, nor coexisting chronic cardiovascular, pulmonary, or renal disease, significantly altered the mortality rate.
On the basis of this experience, a list of seven safeguards is stated that have materially reduced the mortality and morbidity rates in the aged patient.
Gilchrist RK, de Peyster FA. PRINCIPLES AND SAFEGUARDS IN ABDOMINAL SURGERY OF THE AGED. JAMA. 1956;160(16):1375–1378. doi:10.1001/jama.1956.02960510001001
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