An Analysis of the Risk Factors for Postoperative Complications and Their Effects on Hospital Stay in Taiwanese Geriatric Surgical Patients.

BACKGROUND

Surgical outcomes and complications in geriatric patients may be affected due to their increased number of underlying diseases. This study was conducted to evaluate the risk factors for postoperative complications and their effects on hospital stay in geriatric surgical patients (aged ≥ 80 years).

METHODS

A total of 404 geriatric patients (aged ≥ 80 years) who underwent noncardiac surgery were enrolled in this study. Their preoperative, perioperative, and postoperative data were collected and subjected to univariate and multivariate analyses to calculate the odds ratio of risk factors. The risk of discharge was analyzed by calculating the hazard ratio to evaluate their relationship with postoperative complications.

RESULTS

Approximately three-fourths (76.0%) of the patients had hypertension preoperatively, and 5.9% of them developed at least one postoperative complication. Respiratory disorders were the most frequent postoperative complications. Multivariate analysis revealed emergency surgery, preoperative renal diseases, preoperative anemia, and nonextubation as risk factors for postoperative respiratory complications. Intraoperative estimated blood loss of ＞ 500 mL and intraoperative low blood pressure were identified as risk factors for postoperative neurological complications. Intraoperative hypothermia was found to be a risk factor for postoperative renal complications. Postoperative respiratory complications, postoperative neurological complications, and infection statistically significantly prolonged the length of hospital stay. The in-hospital mortality rate was 1.0%.

CONCLUSION

Patients aged ≥ 80 years under certain conditions need more attention to prevent the development of different types of postoperative complications. Those who did develop postoperative respiratory complications, postoperative neurological complications, and infection might require prolonged hospitalization. Physicians must pay more attention preoperatively to the risk factors that increase postoperative complications.