TITLE:
Peri-Operative Morbidity and Mortality of Elderly Patients in Traumatology-Orthopedics in Bouaké
AUTHORS:
Aya Adélaïde Natacha Kouassi, Achié Jean-Régis Akobe, Loukou Blaise Yao, Kouamé Innocent M’bra, Zolopégué Marcel Soro, Ibrahim Soumahoro, Koffi Léopold Krah, Michel Kodo
KEYWORDS:
Comorbidity, Elderly Patient, Mortality, Surgery
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.14 No.11,
November
28,
2024
ABSTRACT: Introduction: Elderly subjects have physiological and clinical characteristics that make surgical management more complex and have a major impact on their prognosis. The primary objective of this study was to assess peri-operative hospital morbidity and mortality in the elderly. Secondary objectives were to identify factors predictive of death. Methods: This was a retrospective observational descriptive and analytical study carried out over 02 years, based on hospitalized patient records. It concerned patients aged 65 or over who had undergone surgery or for whom an indication for surgery had been given, all pathologies included. A total of 138 files were collected. The mean age was 74.15 years. Diabetes (n = 52; 37.68%) and arterial hypertension (n = 38; 27.54%) were the most common comorbidities. The reasons for hospitalization were mostly degenerative (n = 56; 40.58%) and traumatic (n = 49; 35.51%) pathologies. Preoperative delay, intraoperative and postoperative complications, hospital stay, evolution (mode of discharge), time of occurrence and presumed cause of death were studied. Univariate (p Results: The mean preoperative delay was 5.53 days (1 - 23). Intraoperative complications were mainly hemodynamic instability (n = 26, 18.8%). Postoperatively, the main complications were anemia (n = 62; 48.44%) and glycemic imbalance (n = 28; 21.86%). Average hospital stay was 13.4 days. Age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, delay in treatment > 3 days, the occurrence of complications and the blood transfusion requirement were the independent predictors of the occurrence of death in the multifactorial analysis. Conclusion: Peri-operative morbidity in the elderly was influenced by age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, time to treatment > 3 days, the occurrence of complications and the blood transfusion requirement.