Morbidity and mortality rates of elective gynecologic surgery in the elderly woman

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Abstract

Objective

The purpose of this study was to report perioperative morbidity and mortality rates in elderly women who undergo gynecologic surgery.

Study design

The charts of 54 consecutive women ages 70 to 85 years who underwent major gynecologic surgery between June 1998 and November 2002 were reviewed retrospectively.

Results

The mean age was 76.7 years. Fifty procedures (92.6%) were performed for pelvic organ prolapse and/or urinary incontinence. Forty-nine of the procedures were performed vaginally, and 27 of the procedures (50%) were performed with the use of general anesthesia. Postoperative cardiac complications occurred infive patients (10%), including three myocardial infarctions, two of which were fatal. Other complications included benign cardiac arrhythmias in two patients, slow return of gastrointestinal function in five patients (9.3%), and transient mental status changes in four patients (7.4%). The mean length of stay was 4 days.

Conclusion

Postoperative complications occurred infrequently among elderly women who underwent gynecologic surgery. Although age alone is not a contraindication to elective surgery, there may be increased risks for geriatric women.

Section snippets

Material and methods

The office and hospital charts of 54 consecutive women who were ≥70 years old and who underwent elective gynecologic surgery between June 1, 1998, and November 1, 2002, were reviewed retrospectively. We did not include patients who underwent minor gynecologic procedures such as hysteroscopy, curettage, or cone biopsies. All women received care by a single surgeon (M. R. T.). Preoperative variables that were considered included age, diagnosis, medical history, and anesthesia risk assessment. A

Results

Demographics of the population that was studied are reviewed in Table I. The mean age was 76.7 years (range, 70-86 years). Almost one third of the subjects (27.8%) were ≥80 years old. Most of the patients were community dwelling. Two patients resided in an assisted-living facility, and two patients were residents in a long-term care facility. All patients underwent a medical clearance evaluation by their private primary care physician before surgery.

Ten of the 54 patients (18.5%) had no

Comment

It can be anticipated that, as our society ages, demands for gynecologic surgery in elderly women will increase. The US Bureau of the Census has predicted that the proportion of postmenopausal women will increase from 23% of the population in 1995 to 33% of the population in 2050. Our analysis suggests that elderly women can undergo major gynecologic surgery with a small and defined risk of morbidity and death. Postoperative death occurred in 2 of 54 patients (3.7%). Serious postoperative

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Presented at the Twenty-Ninth Annual Meeting of the Society of Gynecologic Surgeons, Anaheim, California, March 5-7, 2003.

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