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Major liver resection in elderly patients: a multi-institutional analysis. J Am Coll Surg 2011 May;212(5):787-95

Date

03/26/2011

Pubmed ID

21435922

DOI

10.1016/j.jamcollsurg.2010.12.048

Scopus ID

2-s2.0-79955579965 (requires institutional sign-in at Scopus site)   87 Citations

Abstract

BACKGROUND: Because of the aging United States population, increase in overall life expectancy, and rising incidence of hepatobiliary tumors, more elderly patients are considered for hepatic resection. The objective of this study was to assess the influence of age on postoperative outcomes after major hepatectomy among a contemporary cohort from 2 high volume centers.

STUDY DESIGN: Demographics, diagnoses, surgical treatments, and postoperative outcomes of patients who underwent major hepatic resection were reviewed.

RESULTS: There were 856 patients who underwent major hepatectomy (resection of 3 or more segments) from 2002 to 2009. Postoperative mortality and morbidity occurred in 53 (6.2%) and 403 (47.1%) patients, respectively. Increasing age was independently associated with postoperative mortality (p = 0.0345). Each 1-year and 10-year increase in age resulted in an odds ratio of mortality after major hepatic resection of 1.036 (95% CI [1.003-1.071]) and 1.426 (95% CI [1.026-1.982]), respectively. This relationship was independent of American Society of Anesthesiology (ASA) score. Increasing age was associated with postoperative sepsis (p = 0.0224, odds ratio for each year 1.025 [range 1.003 to 1.048]) after major hepatic resection, but not overall postoperative morbidity.

CONCLUSIONS: In the contemporary era, increasing age is independently associated with postoperative mortality after major hepatic resection at high volume academic centers.

Author List

Reddy SK, Barbas AS, Turley RS, Gamblin TC, Geller DA, Marsh JW, Tsung A, Clary BM, Lagoo-Deenadayalan S

Author

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Aged, 80 and over
Female
Hepatectomy
Humans
Liver Neoplasms
Logistic Models
Male
Middle Aged
North Carolina
Pennsylvania
Postoperative Complications
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome