Early postoperative mortality in the elderly: a pilot study

Fifty patients aged 70 to 95 years of age were enrolled in the study. All patients had undergone major elective orthopedic procedures due to either osteoarthritis of femoral head or femoral neck fracture. Patients were followed up by telephone interview one month following their discharge. 8 out of 50 patients (16%) were reported dead at follow up. For the majority of the patients who died, the cause of death was directly related to their previous medical history.Despite the detailed preoperative evaluation, and the intensive intraoperative and early postoperative anaesthetic care, most patient's deaths were related to their previous medical history.It is estimated that by the year 2040, people over the age of 65 will constitute approximately 24% of the earth's population. Half of them will need to undergo certain surgical procedures in view of the fact that perioperative morbidity has a 3-fold increase in this subset of patients [1].It becomes quite challenging to distinguish between changes in physiology caused by aging, and the pathophysiology of certain diseases that are very common in the elderly. Functional reserve and maximal capacity of all major organ systems are significantly reduced and may not be able to meet the increased demands associated with acute illness surgery [2]. Postoperative mortality is thought to be associated with increasing age; however the severity of coexisting medical problems seems to be an equally important risk factor [3-5]. The purpose of this study is to evaluate the effect of previous medical conditions on the mortality rate of elderly patients during the early postoperative phase following major orthopedic surgery.All patients (n = 50) aged 70 to 95 years old, that were admitted to our hospital for osteoarthritis of the femoral head or femoral neck fracture between January 2004 to May 2004, were enrolled in the study. The operations performed were total hip arthroplasty for those suffering from osteoarthritis of femoral head and