Prediction of outcome of surgery and anesthesia in patients over 80
J. L. Djokovic and J. Hedley-Whyte
We studied the outcome of surgery in 500 patients over 80 years of age.
Hospital mortality within one month of surgery was 6.2%. The American
Society of Anesthesiologists class 1 to 5 preoperative evaluation scale was
useful in predicting death--less than 1% of class 2 patients died, 4% of
class 3, and 25% of class 4. Six of seven perioperative deaths were caused
by mesenteric infarction. Myocardial infarction was the leading cause of
postoperative death. Twenty-four percent of 141 patients who underwent
upper abdominal surgery required controlled endotracheal ventilation for
more than 24 hours postoperatively; 57% after intrathoracic surgery; and
only 2% after surgery that did not enter pleura or peritoneum. Forty-seven
patients underwent gallbladder surgery, and 27 peripheral underwent
vascular surgery without any hospital fatality. Enflurane appears to be a
safe general anesthetic for sick, elderly patients.
