Surgical procedures in patients during the tenth decade of life.
Surgical procedures in patients during the tenth decade of life.
复制标题
十岁以下患者的外科手术。
作者：
J. Cohen;H. Johnson;S. Eaton;H. Sterman;L. Wise
本研究的目的是确定90岁或以上患者的主要外科手术的结果。我们回顾了该年龄组46例接受外科手术的患者的记录，以确定结果和术后生活质量。总体而言，围手术期死亡率为20%。死亡率不受糖尿病、慢性阻塞性肺病、肾功能衰竭、失血量、手术时间或总住院天数等危险因素的影响。然而，心脏病患者的死亡率明显更高（78%）。总体而言，39%的患者在手术后经历了主观精神状态的恶化。术前可走动的患者中，术后可走动的患者占73%。虽然这项研究表明，围手术期死亡率高，精神状态变化频繁，在这个非常老的年龄组，大多数患者的生活质量和寿命是好的，有力的手术干预似乎是必要的。
The purpose of this study was to determine the outcome of major surgical procedures in patients 90 years of age or older. The records of 46 patients in this age group who underwent surgical procedures were reviewed to determine the outcome and the postoperative quality of life. Overall, the perioperative mortality was 20%. Mortality was not influenced by such risk factors as diabetes mellitus, chronic obstructive pulmonary disease, renal failure, quantity of blood loss, duration of procedure, or total number of hospital days. However, patients with heart disease had a significantly higher mortality rate (78%). Overall, 39% of the patients experienced a subjective deterioration in their mental status after surgery. Of those patients who were ambulatory before surgery, 73% were ambulatory after surgery. Although this study indicates that the perioperative mortality is high and mental status changes frequent in this very elderly age group, the quality of life and longevity of the majority of these patients are good, and vigorous surgical intervention appears warranted.