First Do No Harm: Predicting futility of intervention in geriatric emergency general surgery (10 July 2024)

Summary

Surgical conditions are common in older patient and often require major surgery on frail patients. Strong understanding of the risks for different patients is crucial for decision-making and establishing goals of care. This study in the American Journal of Surgery aimed to find out which clinical factors increase the risk of older patients dying within 30 days of a colectomy or small bowel resection. The results showed that the highest predictors of mortality were American Society of Anesthesiologists (ASA) status 5, septic shock and dialysis. Without risk factors, mortality rates were 11.9% after colectomy and 10.2% after small bowel resection. Patients with all three risk factors had a mortality rate of 79.4% following colectomy and 100% following small bowel resection.