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McVeigh, TP,Al-Azawi, D,O'Donoghue, GT,Kerin, MJ
Assessing the impact of an ageing population on complication rates and in-patient length of stay
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Surgical complications Morbidity and mortality Surgical outcomes Elderly Geriatric PATIENTS AGED 80 MORTALITY MORBIDITY OUTCOMES QUALITY PEOPLE OLDER
Background: Ireland has an ageing population; with the proportion of people aged over 80 years estimated to increase over the next 20 years from 1.1% to 2.1%.Aims: The aim of this study was to examine the demographics of the population served by the surgical department in a tertiary referral centre in the west of Ireland and to examine whether increasing age had an influence on morbidity, mortality and length of stay.Methods: Data pertaining to all surgical admissions over a 6-month period between was collected prospectively using an ACS-NSQIP based proforma. Data collected included patient age, gender, operative intervention, in-patient length of stay, mode of admission and complications related to their admission.Results: A total of 2209 patients were admitted under the care of the general, vascular and breast services in our centre over a 6-month period between August and January. Two thousand and nineteen patients had complete data collected. The average age was 50.37 years (+/-23.62), with 24.12% (n = 533) older than 70 years. Only 12.31% of patients aged younger than 70 years experienced morbidity, compared to 25.10% of older patients. It was shown that there was a stepwise increase with complication rates and hospital in-patient stay across each decade of increasing age.Multivariate analysis showed those factors most predictive of a complication to include emergency admission, major or complex major surgical intervention, female gender and age. Length of stay was also found to have a positive correlation with increasing age (Spearman's Rho, p < 0.001).Conclusion: Increasing age is associated with increased complication rates and increased hospital length of stay. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
DOI 10.1016/j.ijsu.2013.07.016
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