Surgery can be life shortening for the elderly

One in five older patients will suffer a complication after surgery and one in 20 will die, according to a new study headed by Associate Professor David Story from the Department of Anaesthesia at the Austin Hospital in Melbourne. 

He says the first study of its kind to confirm that older patients are more likely to die from complications within a month of their operation.

“We found that unexpectedly high incidence of both complications, with 20% of patients having a serious complication within five days of surgery and a mortality rate of 5% within 30 days of surgery,” Associate Professor Story said.

“If you went from age 70 to 80, the risk of dying doubled and doubled again going from 80 to 90. So in this older group of patients it becomes a much more important process or factor in terms of their post-operative outcome.”

The most common complications were inflammation, also called sepsis where the body becomes inflamed and another being renal impairment, that is a degree of kidney failure.

The research tracked more than 4,000 patients who had surgery at 23 city and regional hospitals around Australia and New Zealand. It found that complications lead to longer hospital stays. Patients with no complications left hospital within five days, those with complications stayed for about 13 days.

The research is published in the British medical journal Anaesthesia.

In other research, Canadian seniors who received home care after discharge from hospital for partial hip surgery (hemiarthroplasty) were 43% less likely to die in the three months following the procedure, says a study published in CMAJ (Canadian Medical Association Journal).

However, less than 16% of elderly patients discharged home after partial hip surgery in the study group received home care.

The study looked at 11,326 men and women aged 65 and older in Quebec who had partial hip surgery between 1997 and 2004. Those who were discharged with home care support were younger, more likely to have been treated in a teaching hospital and lower volume hospitals, and to have stayed more than 7 days in hospital.

They were also more likely to have a trial fibrillation and acute renal failure. Men were at higher risk of death compared to women and those who stayed longer in hospital had increased survival rates.

“Comorbidity, with the exception of a trial fibrillation and acute renal failure, did not seem to influence the likelihood of receiving home care after discharge,” writes Dr Elham Rahme, researcher in epidemiology at the Research Institute of the McGill University Health Centre with coauthors.

“This indicates perhaps that receiving this care may depend on availability, rather than need of the service.”

A report published by the Canadian Institute for Health Information shows that Quebec is the Canadian province that spends the least on home services but has the highest number of home care requests.

The authors conclude that their findings that homecare affects survival rates “has significant public health implications and requires further investigation.”