Abstract
Background
With the aging population worldwide, the number of elderly patients presenting for
liver resection because of liver malignancies is increasing. Data on the perioperative
mortality in this population are limited and contradictory. We performed a systematic
review and meta-analysis to determine the mortality of elderly patients after hepatectomy.
Methods
Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020
guidelines, we searched 3 databases to identify studies that investigated 30-day and
90-day mortality after hepatectomy for patients ≥65 years of age. We categorized the
patients by age into 4 groups (≥65, ≥70, ≥75, and ≥80 years), which were analyzed
separately for mortality. All analyses were conducted with IBM SPSS Statistics for
Windows version 28.
Results
Using PubMed, Embase, and Scopus, we identified 441 articles. After study selection
and quality assessment, we included 66 studies consisting of 29,998 patients in the
final meta-analysis. The pooled estimates for 30-day and 90-day mortality in the ≥65,
≥70, ≥75, and ≥80 age groups years were 1.3% (95% confidence interval 0.59%–2.06%),
2.8% (95% confidence interval 1.80%–3.69%), 3.0% (95% confidence interval 1.68%–4.30%),
and 1.7% (95% confidence interval 1.22%–2.20%) and 2.7% (95% confidence interval 1.45%–3.87%),
2.8% (95% confidence interval 1.49%–4.02%), 5.1% (95% confidence interval 2.76%–7.42%),
and 2.4% (95% confidence interval 0.60%–4.16%), respectively.
Conclusion
This meta-analysis summarizes the 30-day and 90-day mortality rates after liver resection
in the elderly patients. Liver resection in this population selected for surgery appears
to be relatively safe. Advanced age alone may not be a sufficient exclusion criterion
for surgery. These age-specific mortality data can be used to educate patients at
the time of preoperative counseling.
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Article info
Publication history
Published online: August 13, 2022
Accepted:
May 30,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
