Risk factors of serious postoperative outcomes in patients aged?90 years undergoing surgical intervention

Objective: We aimed to identify preoperative and intraoperative factors associated with serious postoperative outcomes, which may help patients and clinicians make better-informed decisions. Methods: We conducted a retrospective study including all patients aged >= 90 years who under-went surgery between January 1, 2011, and January 1, 2021, at Chongqing University Central Hospital. We assessed 30 pre-and intraoperative demographic and clinical variables. Logistic regression was used to identify the independent risk factors for serious postoperative outcomes in patients aged >= 90 years. Results: A total of 428 patients were included in our analysis. The mean age was 92.6 years (SD +/- 2.6). There were 240 (56.1%) females and 188 (43.9%) males. The most common comorbidities were hypertension (44.9%) and arrhythmias (34.8%). The 30-day hospital mortality was 5.6%, and severe morbidity was 33.2%. Based on the multivariate logistic regression classification analysis of the American Society of Anesthesiologists (ASA)>= IV [odds ratio (OR), 5.39, 95% confidence interval (CI), 2.06-14.16, P = .001], emergency surgery (OR, 5.02, 95% CI, 2.85-15.98, P = .001) and chronic heart failure (OR, 6.11, 95% CI, 1.93-13.06, P = .001) were identified as independent risk factors for 30-day hospital mortality, and ASA >= IV (OR, 4.56, 95% CI, 2.56-8.15, P < .001), Barthel index (BI) < 35 (OR, 2.28, 95%CI, 1.30-3.98, P = .001), chronic heart failure (OR, 3.67, 95%CI, 1.62-8.31, P = .002), chronic kidney disease (OR, 4.24, 95%CI, 1.99-9.05, P < .001), general anesthesia (OR, 3.31, 95%CI, 1.91-5.76, P < .001), emergency surgery (OR, 3.72, 95%CI, 1.98-6.99, P < .001), and major surgery (OR, 3.44, 95%CI, 1.90-6.22, P < .001) were identified as independent risk factors for serious postoperative complications.

Automated summary

This study aimed to identify factors associated with serious postoperative outcomes in patients aged 90 years and above. The results showed that factors such as high ASA classification, emergency surgery, and comorbidities like chronic heart failure and chronic kidney disease were independent risk factors for adverse postoperative outcomes.