TITLE:
Assessment of Anaesthetic Risk in Elderly Patients Undergoing Elective Surgery in the Anaesthesia and Intensive Care Department of Gabriel Touré University Hospital
AUTHORS:
Abdoulhamidou Almeimoune, Moustapha Mangané, Thierno Madane Diop, Mahamadoun Coulibaly, Aladji Seidou Dembele, Andre Kassogue, Amadou Gamby, Dramane Sanogo, Alfousseini Soumare, Mahamadou Ballo, Siriman Koita, Harouna Sangare, Djibo Mahamane Diango
KEYWORDS:
Elderly, Anaesthetic Risk, Elective Surgery, Frailty, Perioperative Complications
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.15 No.12,
December
9,
2025
ABSTRACT: Background: As more older adults undergo surgery globally, their multimorbidity and reduced physiological reserves heighten anaesthetic risk. Evidence from low-resource settings is scarce. This study compared the frequency and types of peri-operative and early postoperative anaesthetic adverse events in patients aged 65 or older versus younger adults at Gabriel Touré University Hospital, Mali. Methods: We conducted a cross-sectional, descriptive, and analytical study in the Anaesthesia-Intensive Care Department of Gabriel Touré University Hospital from 1 July to 30 September 2024. All patients ≥ 18 years scheduled for elective surgery with anaesthesia were eligible. Patients were divided into Group I (18 - 65 years) and Group II (≥65 years). Anaesthetic risk was stratified using the American Society of Anesthesiologists (ASA) physical status classification. Emergency procedures, patients Results: Of 389 patients, 86 were included (69 in Group I and 17 in Group II). Hypertension was more frequent in elderly patients (47.1% vs. 10.1%), whereas absence of medical history predominated in younger adults (85.5% vs. 52.9%) (χ2 = 13.224; p = 0.001). Other preoperative clinical, biological, and ASA characteristics were similar between groups. General anesthesia was more often used in younger patients (65.2% vs. 35.3%; χ2 = 5.060; p = 0.024), while regional anesthesia was preferred in older adults (64.7% vs. 33.3%; χ2 = 5.616; p = 0.018). The incidence of intraoperative hemodynamic events and postoperative instability during the first 24 h did not differ significantly between age groups, nor did postoperative destination: approximately 87% of patients in each group were transferred to standard surgical wards and 13% to intensive care. Conclusion: In this single-centre cohort, patients aged ≥ 65 years undergoing elective surgery did not experience a higher rate of peri- or early postoperative anaesthetic complications than younger adults, provided that pre-operative assessment was rigorous and anaesthetic techniques were adapted, with greater use of regional anaesthesia. These findings support the view that chronological age alone should not contraindicate elective surgery under anaesthesia and underline the potential value of incorporating systematic frailty screening to refine risk stratification in elderly patients.