Introduction Against the background of an ageing population, few data are available on surgical outcomes in the elderly. This study aimed to compare outcomes after colorectal resection for benign and malignant disease in patients aged 80 years and above and those under 80.
Method Data were prospectively recorded in a single consultant surgeon database from 2004 to 2014. The primary endpoint was in-hospital mortality. Secondary endpoints were anastomotic leak, 30-day reoperation rate, general and surgical complications, length of stay, readmission rates within 30 days and overall survival. All data were analysed using SPSS.
Results Eighty-eight of 534 patients were aged 80 years and above. Of this elderly cohort, 10 were aged 90 years and above. Median follow-up was 18 months in the elderly cohort vs. 25 months in the younger cohort (p = 0.07). Seventy-nine of 88 (89.8%) resections in the elderly cohort were for malignancy vs. 355 of 446 (79.6%) in the younger cohort (p = 0.04). A significantly higher proportion of patients in the elderly cohort had an ASA status of 3 to 5 (53/88 [60.2%] vs. 180/446 [40.4%] in the younger cohort, p < 0.0001). In-hospital mortality was non-significantly higher in the elderly group (3 of 88 [3.4%] vs. 7 of 446 [1.6%] in the younger group, p = 0.46). Anastomotic leak rates were similar (5 of 88 [5.7%] in the elderly vs. 26 of 446 [5.8%] in the younger group, p = 0.95), as were the 30-day reoperation rate (6/88 [6.8%] vs. 30/446 [6.7%], p = 0.90), general complications (7 of 88 [8.0%] vs. 44/446 [9.9%], p = 0.57), and surgical complications (6/88 [6.8%] vs. 49/446 [11.0%], p = 0.58) respectively. The median length of stay was two days longer in the elderly (12.8 days vs. 10.8 days, p = 0.06). Readmission rates were similar (1/88 [1.2%] in the elderly vs. 18/446 [4.0%], p = 0.61). The overall mean survival time was significantly shorter in the elderly compared to the younger cohort (55 vs. 98 months, p < 0.0001).
Conclusion Elderly patients tended to have more comorbidities which were reflected in a longer hospital stay compared with the younger cohort and had poorer overall survival, which is expected in the over 80s. Other outcomes were not significantly different, suggesting that colorectal resection has acceptable outcomes in the elderly and should be considered in selected patients.
Disclosure of interest None Declared.