Operations The biological constitution is more important than the year

Until which age should one go under the knife?

The surgical methods are constantly improving and thus also the burden on the patient. For elderly patients, surgery is a higher risk of developing complications. But when is a patient too old to undergo surgery? Should an 85-year-old still under the knife or better not? Scientists at the St. Michael's Hospital in Toronto dedicated a meta-analysis to this question. The aim of the study was to identify the prognostic factors associated with the development of postoperative complications in the elderly.

The researchers found in analyzing more than 12,000 patients from 44 studies that a patient's age was no reason to forego surgery. Doctors should be more guided by a patient's biological age than the actual one. The scientists identified prognostic factors that could be helpful in deciding whether an operation makes sense or is too dangerous. These factors include, for example, the frailty and depressive symptoms of the patient. Even if someone is a smoker or not plays a role. The results of the analysis were published in the journal "BMC Medicine".

In the case of operations performed in patients of advanced age, it is not the age that decides but rather the general condition about the possible occurrence of postoperative complications. (Image: Photographee.eu/fotolia.com)

Common complications of surgery in old age

According to the studies, every fourth case presents with postoperative complications leading to prolonged hospitalization. About 10 percent of elderly patients can not return to the previous environment after surgery. On average, one in twenty patients died within 30 days of surgery. The researchers discovered, however, that age is not solely responsible for these effects. Rather, the general condition of those affected was decisive.

The old methods are inaccurate

The researchers found that the traditional methods used to date for evaluation can not provide reliable predictions about the occurrence of complications. So far, only the age of the patient and the risk classification of the "American Society of Anesthesiologists" frequently used in anesthesia have been taken into account. According to the scientists, these methods proved unreliable.

Which factors actually decide on a risk of complications?

A poor general condition, according to the study results, increases the risk of postoperative complications by two and a half times. Smokers also showed an increased risk potential. In addition, the condition of frailty affects the risk of complications. But not only physical factors play a role. Patients who suffered from depression or cognitive impairment also had an increased risk of complications.

The biological age counts

The results of the meta-analysis are clear: the numerical age of the patients does not decide whether or not there will be complications after surgery. Even patients in old age do not have to do without an intervention when they are in a good general condition. The study also points to measures that can reduce the risk of postoperative complications. These include a healthy pre-surgery diet, physical fitness, quitting smoking, or therapy in the case of depression. Doctors are advised to look more closely at biological age and to include factors such as general condition, frailty and cognitive status. (Vb)