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Peri-interventional outcome study in the elderly in Europe: A 30-day prospective cohort study.


ABSTRACT:

Objectives

The aim of this study was to describe the 30-day mortality rate of patients aged 80 years and older undergoing surgical and nonsurgical procedures under anaesthesia in Europe and to identify risk factors associated with mortality.

Design

A prospective cohort study.

Setting

European multicentre study, performed from October 2017 to December 2018. Centres committed to a 30-day recruitment period within the study period.

Patients

Nine thousand four hundred and ninety-seven consecutively recruited patients aged 80 years and older undergoing any kind of surgical or nonsurgical procedures under anaesthesia.

Main outcome measures

The primary outcome was all-cause mortality within 30 days after procedure described by Kaplan-Meier curves with 95% CI. Risk factors for 30-day mortality were analysed using a Cox regression model with 14 fixed effects and a random centre effect.

Results

Data for 9497 patients (median age, 83.0 years; 52.8% women) from 177 academic and nonacademic hospitals in 20 countries were analysed. Patients presented with multimorbidity (77%), frailty (14%) and at least partial functional dependence (38%). The estimated 30-day mortality rate was 4.2% (95% CI 3.8 to 4.7). Among others, independent risk factors for 30-day mortality were multimorbidity, hazard ratio 1.87 (95% CI 1.26 to 2.78), frailty, hazard ratio 2.63 (95% CI 2.10 to 3.30), and limited mobility, hazard ratio 2.19 (95% CI 1.24 to 3.86). The majority of deaths (76%) occurred in hospital. Mortality risk for unplanned ICU admission was higher, hazard ratio 3.57 (95% CI 2.38 to 5.26) than for planned ICU admission, hazard ratio 1.92 (95% CI 1.47 to 2.50). Compared with other studies, the in-hospital complication rates of 17.4 and 3.9% after discharge were low. Admission to a unit with geriatric care within 30 days after the intervention was associated with a better survival within the first 10 days.

Conclusions

The estimated 30-day mortality rate of 4.2% was lower than expected in this vulnerable population.

Trial registration

ClinicalTrials.gov Identifier: NCT03152734, https://clinicaltrials.gov.

SUBMITTER: POSE-Study group 

PROVIDER: S-EPMC8815832 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Peri-interventional outcome study in the elderly in Europe: A 30-day prospective cohort study.

European journal of anaesthesiology 20220301 3


<h4>Objectives</h4>The aim of this study was to describe the 30-day mortality rate of patients aged 80 years and older undergoing surgical and nonsurgical procedures under anaesthesia in Europe and to identify risk factors associated with mortality.<h4>Design</h4>A prospective cohort study.<h4>Setting</h4>European multicentre study, performed from October 2017 to December 2018. Centres committed to a 30-day recruitment period within the study period.<h4>Patients</h4>Nine thousand four hundred an  ...[more]

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