Advertisement

Letter to the Editor: Risk Factors for Mortality and Morbidity in Elderly Patients Presenting with Digestive Surgical Emergencies

  • Hui-Xian Li
  • Fu-Shan Xue
  • Ya-Yang Liu
Letter to the Editor

The recent article by Hentati et al. [1] determining the predictors of mortality and morbidity following emergency digestive surgery in patients aged 80 years and older was of great interest. By multivariate binary logistic regression analysis, they show that pulmonary disease, bowel ischemia, postoperative ICU stay and the occurrence of postoperative complications are predictors of 90-day mortality, but an age ≥80 years is not associated with 90-day mortality. Other than the limitations described in discussion section, we note that some methodological issues seem important to avoid any optimistic interpretation or misinterpretation of results.

First, multivariate analysis shows that preoperative hemoglobin < 12 g/dL is a predictor of in-hospital morbidity. In patients’ demographic data, however, only mean preoperative hemoglobin levels were provided and compared. According to World Health Organization criteria,1preoperative anemia is defined as a hemoglobin level <12.0 g/dl for...

Notes

Compliance with ethical standards

Conflict of interest

All authors have no financial support and potential conflicts of interest for this work.

References

  1. 1.
    Hentati H, Salloum C, Caillet P et al (2018) Risk factors for mortality and morbidity in elderly patients presenting with digestive surgical emergencies. World J Surg.  https://doi.org/10.1007/s00268-017-4419-3 Google Scholar
  2. 2.
    Beattie WS, Karkouti K, Wijeysundera DN et al (2009) Risk associated with preoperative anemia in noncardiac surgery: a single-center cohort study. Anesthesiology 110(3):574–581CrossRefPubMedGoogle Scholar
  3. 3.
    Wu WC, Schifftner TL, Henderson WG et al (2007) Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. JAMA 297(13):2481–2488CrossRefPubMedGoogle Scholar
  4. 4.
    Leung JM, Dzankic S (2001) Relative importance of preoperative health status versus intraoperative factors in predicting postoperative adverse outcomes in geriatric surgical patients. J Am Geriatr Soc 49(8):1080–1085CrossRefPubMedGoogle Scholar
  5. 5.
    Hosmer DW, Lemeshow S et al (2013) The multiple logistic regression model: applied logistic regression, 3rd edn. Wiley, New York, pp 35–47Google Scholar
  6. 6.
    Akinbami F, Askari R, Steinberg J et al (2011) Factors affecting morbidity in emergency general surgery. Am J Surg 201(4):456–462CrossRefPubMedGoogle Scholar
  7. 7.
    Cihoric M, Toft Tengberg L et al (2016) Prediction of outcome after emergency high-risk intra-abdominal surgery using the Surgical Apgar Score. Anesth Analg 123(6):1516–1521CrossRefPubMedGoogle Scholar
  8. 8.
    Kinoshita M, Morioka N, Yabuuchi M et al (2017) New surgical scoring system to predict postoperative mortality. J Anesth 31(2):198–205CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology, Plastic Surgery HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China
  2. 2.Department of AnesthesiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingPeople’s Republic of China

Personalised recommendations