Assessment of Anaesthetic Risk in Elderly Patients Undergoing Elective Surgery in the Anaesthesia and Intensive Care Department of Gabriel Touré University Hospital

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 < 18 years, incomplete or lost files, and pre-operative decompensation of comorbidities were excluded. Pre-operative clinical status, comorbidities, laboratory results, and ASA class were collected. Intra-operative data included types of anaesthesia, induction technique, and haemodynamic events (tachycardia, bradycardia, hypotension, hypertension). Postoperative monitoring during the first 24 h focused on blood pressure, heart rate, oxygen saturation, and destination after the post-anaesthesia care unit. Data were analysed with IBM SPSS Statistics 22.0 using Pearson’s chi-square test (p < 0.05). 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