Adverse events in ambulatory surgery. A comparison between elderly and younger patients

  • Frances ChungEmail author
  • Gabor Mezei
  • Doris Tong
Reports of Investigation



An increasing number of elderly patients are undergoing ambulatory surgery. We examined whether ambulatory surgery carries a higher risk for the elderly than for younger patients.


A total of 17,638 consecutive ambulatory surgical patients were enrolled in a prospective cohort study during a three-year period. Preoperative, intraoperative, and postoperative information was collected. Twentyseven percent of the enrolled patients were 65 yr or older. Incidence rates of intraoperative and postoperative adverse events among the elderly were compared with those among younger patients; we controlled for sex, ASA physical status, body mass index, type of surgery, and duration of procedure, using multiple logistic regression models.


Elderly patients had a higher incidence of any intraoperative event (adjusted odds ratio, 1.4; 99.7% confidence interval [CI], 1.0–2.0) and of intraoperative cardiovascular events (adjusted odds ratio, 2.0; 99.7% CI, 1.3–3.0). They also had a lower incidence of any postoperative event (adjusted odds ratio, 0.4; 99.7% CI, 0.3–0.6) and of postoperative pain (adjusted odds ratio, 0.2; 99.7% CI, 0.1–0.4), nausea and vomiting (adjusted odds ratio, 0.3; 99.7% CI, 0.1–0.6), and dizziness (adjusted odds ratio, 0.4; 99.7% CI, 0.2–1.0).


The risks reported do not constitute a contraindication for elderly patients to undergo ambulatory surgery but this population may require more careful intraoperative cardiovascular management.


Operating Room Adjusted Odds Ratio Malignant Hyperthermia Postoperative Event Postoperative Adverse Event 
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Un nombre croissant de patients âgés se retrouvent en chirurgie ambulatoire. Nous avons chercher à savoir si la chirurgie ambulatoire comporte un plus grand risque pour les gens âgés comparés aux jeunes patients.


Ce sont 17 638 patients qui se sont présentés successivement en chirurgie ambulatoire qui ont été recrutés pour une étude comparative des cohortes qui a duré trois ans. On a recueilli les renseignements préopératoires, peropératoires et postopératoires nécessaires. Parmi les patients choisis, 27% avaient 65 ans ou plus. On a comparé l’incidence des effets secondaires peropératoires et postopératoires entre les patients âgés et les jeunes patients selon le sexe, l’état physique ASA, l’indice de masse corporelle, le type de chirurgie et la durée de l’opération, en utilisant des modèles de régression logistique multiple.


Les patients âgés présentaient une plus forte incidence de tout événement peropératoire (coefficient de risque ajusté, 1,4; intervalle de confiance de 99,7% [IC], 1,0 – 2,0) et d’incidents cardiovasculaires peropératoires (CR ajusté, 2,0; IC de 99,7%, 1,3 – 3,0). Ils présentaient, par ailleurs, une plus faible incidence de tout événement postopératoire (CR ajusté, 0,4; IC de 99,7%, 0,3 – 0,6) et de douleur (CR ajusté, 0,2; IC de 99,7%, 0,1 – 0,4), de nausées et de vomissements (CR ajusté, 0,3; IC de 99,7%, 0,1 – 0,6), et d’étourdissement postopératoires (CR ajusté, 0,4; IC de 99,7%, 0,2 – 1,0).


Les risques rapportés ne constituent pas une contre-indication à la chirurgie ambulatoire pour les gens âgés, mais cette population demande qu’on soit plus attentif aux risques cardiovasculaires peropératoires.


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Copyright information

© Canadian Anesthesiologists 1999

Authors and Affiliations

  1. 1.Department of AnaesthesiaToronto Western Hospital, University of TorontoTorontoCanada

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