Emergency surgery in patients aged over 70 years

Our review of all general surgical procedures at the Mount Sinai Hospital performed in one year in persons over 70 showed that in 100 patients who required emergency surgery, morbidity was 31% and mortality 20%-significantly greater than the 6.8% morbidity (p<0.0005) and 1.9% mortality (p<0.0005) in 513 patients of the same age group who underwent elective procedures during the same interval, Nov. 1, 1983 through Oct. 31, 1984. Infection was the most common indication for urgent operation (28%), followed by intestinal obstruction (25%), incarcerated hernia (17%), and hemorrhage (13%). The majority of complications were related to the cardiopulmonary systems; 80% (16/20) of deaths occurred from multisystem failure in the intensive-care unit. No correlation was found between increasing age and morbidity or mortality. We believe that improvement in medical care of the elderly will come not from technologic advances but from better understanding of their social conditions and biologic capabilities.