Postoperative Mortality and Morbidity Rate of Elderly Patients in Buriram Hospital.
Article Sidebar
Main Article Content
Abstract
Background: Nowadays, Thailand has developed effectiveness health care system, population's mean age has been increased. Buriram hospital has raised health service in surgery for elderly people too.
Objective: To study an incident of postoperative morbidity and mortality rate of elderly patients in Buriram hospital.
Method: Descriptive retrospective study was done. Medical records of elderly patients in general surgery department of Buriram hospital were reviewed since October 2006 to July 2007.
Population: Patients aged more than 70 years, who were operated in general surgery under general anesthesia, or local anesthesia in Buriram hospital.
Statistics: Descriptive statistics demonstrated in percentage, mean, median standard deviation (SD), outcome and risk factors were analyzed by multivariated analysis and odd ratio with p < 0.05 consider significant with computer soft ware program.
Results: There were 362 cases include in this study. The patients's median aged was 72 years (70-96 years) and 62.2% were male, The final diagnosis were acute appendicitis in 15.3%, trauma in 12.5%, peptic ulcer and complications in 9.5%, cholecystitis in 6.4% and inguinal hernia in 5.9%. The postoperative mortality and morbidity rate were 5.5% and 33.1%, respectively. The three most common postoperative complications were renal failure (6.1%), sepsis (3.6%), Pneumonia (3.6%). The mortality rate was significant increased in patients who had comorbidity diseases (p = 0.042). Sex, age more than 80 years and postoperative complications that were not directed caused by surgery (renal failure, sepsis, and pneumonia) had no effect in postoperative mortality.
Conclusion: The postoperative mortality and morbidity rate of elderly patients who underwent general surgery in Buriram hospital were 5.5% and 33.1% respectively. The factors associated with mortality rate were comorbidity diseases and patient status.
Keyword: postoperative outcome, elderly patient, sepsis, renal failure, pneumonia
Article Details
References
2. Ross AF, Tinker JH. Anesthesia risk. In : Miller RD, ed. Anesthesia 3rd edition. New York : Churchill-Livingstone. 1990:716-42
3. สมรัตน์ จารุลักษณานันท์, ฐิติมา ชินะโชติ, อักษร พูลนิติพร, ศิริลักษณ์ กล้าณรงค์, อรลักษณ์ รอดอนันต์, สุรศักดิ์ ถนัดศีลธรรม. การศึกษาอุบัติการณ์การเสียชีวิตหลังให้ยาระงับความรู้สึก สำหรับการผ่าตัดในประเทศไทย : การวิเคราะห์ปัจจัยเสี่ยง. J Med Assoc Thai 2548;88:S38-S40
4. Arbors MS, Meursing AE, Van Kleef JW, de Lunge JS, Spoormans HH, Touw P, et al. Impact of anesthesia management characteristics on severe morbidity and mortality. Anesthesiology 2005;102:251-2
5. Bufalari A, ferri M, Cao P, et al. Surgical care in octogenarians. Br J Surg 1996;83:1783-7
6. Larry McNicol, David A Story, Kate Leslie, Paul S, Myles Michael Fink, Andrew C Shelton, et al. Postoperative complications and mortality in older patients having non-cardiac surgery at three Melbourne teaching hospitals. MJA 2007;186:447-52.
7. Hamel MB, Henderson WG, Khuri SF, Daley J. Surgical outcomes for patients aged 80 and older : morbidity and mortality for major noncardiac surgery. J Am Geriatr Soc 2005;53:424-9.
8. Leung JM, Dzankic S. Relative importance of preoperative health status versus intraoperative factors in predicting postoperative adverse outcomes in geriatric surgical patients. J Am Geriatr Soc 2001;49:1080-5.
9. Liu LL, Leung JM. Predicting adverse postoperative outcomes in patients aged 80 years or older. J Am Geriatr Soc 2000;48:405-12.
10. Walters U, Wolf T, Schrader T. ASA classification and preoperative Variables as predictors of postoperative outcome. Br J Anaesth 1996;76:217-22.
11. พัชรี ยิ้มรัตนบวร. อัตราตายของผู้ป่วยที่มารับบริการทางวิสัญญีตามสภาพก่อนผ่าตัด. วิสัญญีสาร. 2549; 32:13-8.
