| Abstract: | During the hospital course of 225 nonagenarian patients who underwent 285 major operations—80% on the general, vascular, orthopedic and urologic services—overall morbidity was 37% and mortality 7.5%. The 100 emergency operations were associated with a higher morbidity and mortality rate. Nonsurvivors were more likely to have associated cardiac or cerebral medical conditions, higher utilization of intraoperative invasive hemodynamic monitoring and greater use of surgical intensive care units. Compared with all surgical patients, the nonagenarians were admitted twice as often to the surgical intensive care unit, required twice the number of hospital days, underwent intraoperative hemodynamic monitoring twice as frequently and incurred 200% greater hospital charges. We conclude that with careful evaluation and management, a nonagenarian patient presenting with a surgical condition can safely undergo necessary operative procedures. |
