• Emin Lapsekili, Abdulkadir Deniz, and Suleyman Utku Celik.
• Gulhane Training and Research Hospital, Department of General Surgery - Ankara, Turkey.
• Rev Assoc Med Bras (1992). 2021 Oct 1; 67 (10): 1485-1490.

ObjectiveAppendicitis in elderly patients is more challenging due to delayed presentation and higher comorbidities, which are associated with increased postoperative morbidity. The aim of this study was to evaluate factors that predict 30-day complications in elderly patients undergoing appendectomy.MethodsThe records of elderly patients who underwent appendectomy were reviewed. The primary outcome was 30-day postoperative complications. Independent variables examined included demographic data, comorbidities, preoperative laboratory values, pathological findings, and surgical features. Both univariate and multivariate regression analyses were performed to identify factors associated with postoperative complications.ResultsEvaluation was performed on 80 patients, comprising 63.8% females with a mean age of 71.3 years. Notably, 19 (23.8%) patients had one or more complications within 30 days after surgery. No significant difference was found between patients with and without complications in respect of age, gender, or laboratory features. The rates of American Society of Anesthesiologists scores 3-4 (p=0.006), hypertension (p=0.016), cardiovascular disease (p=0.049), and obesity (p=0.040) were significantly higher for patients with complications than for those without. On multivariate analysis, obesity (OR 9.41), chronic obstructive pulmonary disease (OR 9.72), and open appendectomy (OR 14.87) were independently associated with 30-day postoperative complications.ConclusionsOlder patients undergoing appendectomy tend to have poorer outcomes than younger patients. Therefore, it is critical to identify factors that could reduce the possibility of adverse outcomes in this frail population. The results of this study suggest that obesity, chronic obstructive pulmonary disease, and an open approach are independent factors for complications in elderly patients undergoing appendectomy.

16 keywords...

hide…