TY - JOUR
T1 - Outcomes of operations for benign foregut disease in elderly patients
T2 - A National Surgical Quality Improvement Program database analysis
AU - Molena, Daniela
AU - Mungo, Benedetto
AU - Stem, Miloslawa
AU - Feinberg, Richard L.
AU - Lidor, Anne O.
PY - 2014/8
Y1 - 2014/8
N2 - Background The development of minimally invasive operative techniques and improvement in postoperative care has made surgery a viable option to a greater number of elderly patients. Our objective was to evaluate the outcomes of laparoscopic and open foregut operation in relation to the patient age. Methods Patients who underwent gastric fundoplication, paraesophageal hernia repair, and Heller myotomy were identified via the National Surgical Quality Improvement Program (NSQIP) database (2005-2011). Patient characteristics and outcomes were compared between five age groups (group I: ≤65 years, II: 65-69 years; III: 70-74 years; IV: 75-79 years; and V: ≥80 years). Multivariable logistic regression analysis was used to predict the impact of age and operative approach on the studied outcomes. Results A total of 19,388 patients were identified. Advanced age was associated with increased rate of 30-day mortality, overall morbidity, serious morbidity, and extended length of stay, regardless of the operative approach. After we adjusted for other variables, advanced age was associated with increased odds of 30-day mortality compared with patients <65 years (III: odds ratio 2.70, 95% confidence interval 1.34-5.44, P =.01; IV: 2.80, 1.35-5.81, P =.01; V: 6.12, 3.41-10.99, P <.001). Conclusion Surgery for benign foregut disease in elderly patients carries a burden of mortality and morbidity that needs to be acknowledged.
AB - Background The development of minimally invasive operative techniques and improvement in postoperative care has made surgery a viable option to a greater number of elderly patients. Our objective was to evaluate the outcomes of laparoscopic and open foregut operation in relation to the patient age. Methods Patients who underwent gastric fundoplication, paraesophageal hernia repair, and Heller myotomy were identified via the National Surgical Quality Improvement Program (NSQIP) database (2005-2011). Patient characteristics and outcomes were compared between five age groups (group I: ≤65 years, II: 65-69 years; III: 70-74 years; IV: 75-79 years; and V: ≥80 years). Multivariable logistic regression analysis was used to predict the impact of age and operative approach on the studied outcomes. Results A total of 19,388 patients were identified. Advanced age was associated with increased rate of 30-day mortality, overall morbidity, serious morbidity, and extended length of stay, regardless of the operative approach. After we adjusted for other variables, advanced age was associated with increased odds of 30-day mortality compared with patients <65 years (III: odds ratio 2.70, 95% confidence interval 1.34-5.44, P =.01; IV: 2.80, 1.35-5.81, P =.01; V: 6.12, 3.41-10.99, P <.001). Conclusion Surgery for benign foregut disease in elderly patients carries a burden of mortality and morbidity that needs to be acknowledged.
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U2 - 10.1016/j.surg.2014.04.005
DO - 10.1016/j.surg.2014.04.005
M3 - Article
C2 - 24973127
AN - SCOPUS:84904247707
SN - 0039-6060
VL - 156
SP - 352
EP - 360
JO - Surgery (United States)
JF - Surgery (United States)
IS - 2
ER -