Gastric surgery in the aged

Summary

In reviewing a group of seventy-four patients subjected to gastric surgery who were sixty years old or older, an overall mortality rate of 16.2% was found. Comparing this mortality rate with the 10% mortality for all gastric surgery in series of four hunded and eighteen patients operated upon between the years of 1943–1947, we see an apparent increase which would appear to be due to the older age of the patient. In reviewing the cause of death, however, we find that the same proportion of deaths occurred in the sixty to seventy year old group as in the seventy, to eighty year old group. We note 79% of all patients operated upon in this series to be between the ages of sixty to seventy, whereas 18% of the patients were between the ages of seventy to eighty and 2.7% of the patients were over the age of eighty. In studying the causes of death, 75% of all deaths occurred in the sixty to severity year old group and 25% of the deaths were found in the seventy to eighty year old group. From these figures, it should be obvious that the age of the patient alone had nothing to do with the death of the patient.

A scrutiny of the causes of death again reveals the startling fact that only one patient died of cardiac failure. This might conceivably he attributed to the age of the patient, yet this patient was only sixty four years old. Eight of the patients died of peritonitis (66%) and three of the patients (lied of post operative hemorrhage (25%). Since both of these causes may more rightly be attributed to faulty surgical technic, we must conclude that 91% of all deaths in this older age group were not the result of the age of the patient per se.