OUTCOME OF ELDERLY PATIENTS UNDERGOING ACUTE SURGICAL PROCEDURES: A STUDY IN MARKS MEDICAL COLLEGE & HOSPITAL, DHAKA, BANGLADESH

Iqbal Masud Khan*, Nishat Farhana Khan, Md. Zakir Hossain, Nabaneeta Sarker and Nayeem

ABSTRACT

Introduction: Life expectancy and the geriatric population have increased steadily in recent decades. By 2030, people more than 65 years will account for 20% of overall population. The society is continuing to age and with luck, fortunately this trend is continuing. Objective: To evaluate the outcome of elderly patients undergoing acute surgical procedures. Methods: This was a non-comparative and non-randomized prospective clinical study in MARKS Medical College & Hospital, Dhaka, Bangladesh during from January to December-2017. All the patients of age 65 years & above who underwent emergency general surgeries under general/epidural/spinal anaesthesia in the institute were included in the study. Patients comorbid conditions, post-hospital complications and in-hospital mortality were assessed. Charlson Comorbidity Index Score was calculated. Results: More than one third of patients were between 65-70 years of age (46.3%). Perforation peritonitis was the most common diagnosis (46.3%). The overall mortality was in 5 (9.3%, 95%CI=4.0-19.9) patients. Diabetes mellitus and hypertension was present among 44.4% and 40.7% patients respectively. Charlson Comorbidity Index <5 was among 53.7% patients and Charlson Comorbidity Index ≥5 was among 46.3% patients. Gastrointestinal was the most common post-op complication (48.1%). Conclusion: The surgical outcome of a surgical operation in the elderly will be dependent on the physical status of the patient preoperatively. More than the age per say, the delay in presentation may be the cause for mortality in this age group.

Keywords: Geriatric patients, Charlson comorbidity index; Comorbidity, Mortality, Emergency.