Abstract
Objective: To examine the relationship between the age of cholecystectomy patients and surgical complications, length of stay, symptom relief, and postdischarge functional status.
Design: Patients’ medical records were reviewed and patients were sent a questionnaire three months after hospital discharge.
Setting: Four university-affiliated teaching hospitals.
Patients: 372 patients who had a primary operation of total cholecystectomy.
Outcome measures: In-hospital complications, length of stay, patient satisfaction, symptom relief, and functional status after discharge.
Results: Patients over the age of 60 years experienced a higher major postoperative complication rate than did younger patients (p<0.01), although the overall major complication rate was too low to determine whether factors other than age were important predictors. There was no age-related difference in minor postoperative complication rates. The older patients had a longer mean length of stay, even after statistical adjustment for covariates (p<0.05). The older patients reported similar levels of patient satisfaction, but reported recurrence of pre-operative abdominal pain less often than did the younger patients (OR=0.4, 95% CI=0.2, 0.7). There was no statistically significant difference between the older and younger patients in postoperative functioning, except for work performance. The younger patients reported improvement in postoperative work performance, while the older patients reported a decline (p < 0.01).
Conclusions: Older cholecystectomy patients may experience more postoperative complications but report less recurrence of preoperative abdominal pain than do younger patients. The decline in work performance in older patients may indicate the need for a longer recuperation period.
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References
Graves EJ. Detailed diagnoses and procedures, National Hospital Discharge Survey: 1987. Hyattsville, MD: National Center for Health Statistics. Vital Health Statistics, 1989;Series 13.
Glenn F. Surgical management of acute cholecystitis in patients 65 years of age and older. Ann Surg. 1983;193:56–9.
NIH Consensus Conference. Gallstones and laparoscopic cholecystectomy. JAMA. 1993;269:1018–24.
Smith N, Max MH. Gallbladder surgery in patients over 60: is there an increased risk? South Med J. 1987;80:472–4.
Harbrecht PJ, Garrison RN, Fry DE. Surgery in elderly patients. South Med J. 1981;74:594–8.
Hidalgo LA, Capella G, Pi-Figueras J, et al. The influence of age on early surgical treatment of acute cholecystitis. Surg Gynecol Obstet. 1989;169:393–6.
Sandier RS, Maule WF, Baltus ME, Holland KL, Kendall MS. Biliary tract surgery in the elderly. J Gen Intern Med. 1987;2:149–54.
Cleary PD, Greenfield S, Mulley AG, et al. Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California. JAMA. 1991;266:73–9.
Owens WD, Felts JA, Spitznagel EL Jr. ASA Physical Status Classifications: a study of consistency of ratings. Anesthesiology. 1978;49:239–43.
Greenfield S, Blanco DM, Elashoff RM, Ganz PA. Patterns of care related to age of breast cancer patients. JAMA. 1987;257:2766–70.
Cleary PD, Greenfield S, McNeil BJ. Assessing quality of life after surgery. Controlled Clin Trials. 1991;12(suppl):189S-203S.
Jette AM, Davies AR, Cleary PD, et al. The Functional Status Questionnaire: its reliability and validity when used in primary care. J Gen Intern Med. 1986;1:143–9.
Kerlinger FN, Pedhazur EJ. Multiple regression in behavioral research. New York: Holt, Rinehart and Winston, 1973.
Bodvall B, Overgaard B. Computer analysis of postcholecystectomy biliary tract symptoms. Surg Gynecol Obstet. 1967;124:723–32.
Mitchell JH, Hardacre JM, Wenzel FJ, Lohrenz FN. Cholecystectomy peer review: measurement of four variables. Med Care. 1975;13:409–16.
Scher KS, Scott-Conner CEH. Complications of biliary surgery. Am Surg. 1987;53:16–21.
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Supported in part by grants from the National Institute on Aging (AGO833101), the Robert Wood Johnson Foundation, and the John A. Hartford Foundation.
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Mort, E.A., Guadacnoli, E., Schroeder, S.A. et al. The influence of age on clinical and patient-reported outcomes after cholecystectomy. J Gen Intern Med 9, 61–65 (1994). https://doi.org/10.1007/BF02600200
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DOI: https://doi.org/10.1007/BF02600200