Background
Geriatric patients remain largely unstudied in low-middle income health care settings.
The purpose of this study was to compare the epidemiology and outcomes of older versus
younger adults with emergency general surgical conditions in South Asia.
Methods
Discharge data from March 2009 to April 2014 were obtained for all adult patients
(≥16 years) with an International Classification of Diseases, 9th revision, Clinical
Modification diagnosis codes consistent with an emergency general surgery condition
as defined by the American Association for the Surgery of Trauma. Multivariable regression
analyses compared patients >65 years of age with patients ≤65 years for differences
in all-cause mortality, major complications, and duration of hospital stay. Models
were adjusted for potential confounding owing to patient demographic and clinical
case-mix data with propensity scores.
Results
We included 13,893 patients; patients >65 years constituted 15% (n = 2,123) of the cohort. Relative to younger patients, older adults were more likely
to present with a number of emergency general surgery conditions, including gastrointestinal
bleeding (odds ratio OR [95% CI], 2.63[1.99–3.46]), resuscitation (2.17 [1.67–2.80]),
and peptic ulcer disease (2.09 [1.40–3.10]). They had an 89% greater risk-adjusted
odds (1.89 [1.55–2.29]) of complications and a 63% greater odds (1.63 [1.21–2.20])
of mortality. Restricted to patients undergoing operative interventions, older adults
had 95% greater odds (1.95 [1.29–2.94]) of complications and 117% greater odds (2.17
[1.62–2.91]) of mortality.
Conclusion
Understanding unique needs of geriatric patients is critical to enhancing the management
and prioritization of appropriate care in developing settings.
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Article info
Publication history
Published online: May 18, 2015
Accepted:
March 31,
2015
Footnotes
Conflicts of Interest: None to declare.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
