Digestive Diseases and Sciences

, Volume 58, Issue 10, pp 2955–2962 | Cite as

Surgical Outcomes in the Elderly with Inflammatory Bowel Disease are Similar to Those in the Younger Population

  • Marita C. Bautista
  • Mary F. Otterson
  • Yelena Zadvornova
  • Amar S. Naik
  • Daniel J. Stein
  • Nanda Venu
  • Lilani P. Perera
Original Article
First Online:
Received:
Accepted:

Abstract

Background

Inflammatory bowel disease (IBD) has a bimodal distribution with approximately 15 % of patients manifesting after age 65. Previous reports suggest an increased risk of surgical complications in the elderly.

Aim

To compare surgical outcomes in elderly IBD patients (≥65 years at the time of surgery) to matched younger IBD cohorts.

Methods

This was a retrospective cohort study at a single academic center of patients who underwent surgery for IBD. Forty-two elderly patients (≥65 years) were matched at least 1:1 (median 1:5) to patients in each of three control groups [18–35 years (n = 71); 36–49 years (n = 62); 50–64 years (n = 58)] according to gender, disease type/location, and type of surgery. Postoperative complications were compared. Patient characteristics were used in multivariate risk models. Analysis was performed using ordinary logistic regression.

Results

Twenty ileal or ileocolonic resections, 12 partial or total colectomies, four stricturoplasties, and six laparoscopic partial or total colectomies were performed in the elderly group. The post-operative complication rate was not statistically different between the elderly and younger cohorts (38 % vs. 39 % vs. 40 % vs. 48 % in the 18–35, 36–49, 50–64, and ≥65 years groups, respectively, p = 0.26). The only significant risk factors for complication were Charlson comorbidity index (p = 0.0002), preoperative hemoglobin (p = 0.0065), total parenteral nutrition use (p = 0.024), and failed medical therapy (as the indication for surgery) (p = <0.0001).

Conclusions

The surgical complication rate among elderly and younger IBD patients was similar. Advanced age by itself should not be considered a risk factor for adverse operative outcome.

Keywords

Inflammatory bowel diseases Aged Outcomes assessment Surgical procedures Gastrointestinal 
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Notes

Acknowledgments

We would like to thank Daniel Eastwood, MS for his work on our statistical analysis.

Conflict of interest

None.

Supplementary material

10620_2013_2754_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 kb)

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Marita C. Bautista
    • 3
  • Mary F. Otterson
    • 2
  • Yelena Zadvornova
    • 1
  • Amar S. Naik
    • 1
  • Daniel J. Stein
    • 1
  • Nanda Venu
    • 1
  • Lilani P. Perera
    • 1
    • 4
  1. 1.Division of Gastroenterology and Hepatology, Department of MedicineMedical College of WisconsinMilwaukeeUSA
  2. 2.Division of Colorectal Surgery, Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  3. 3.Department of MedicineKaiser Permanente Medical CenterSanta ClaraUSA
  4. 4.Clement J. Zablocki VA Medical CenterMilwaukeeUSA

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