Geriatrics
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A study of 194 male lower extremity amputees, with an average age of 56.8 years, showed that vascular disease is the most common cause of limb loss at all ages. Increasing age was correlated with an increasing incidence of bilateral amputation and arteriosclerotic and pulmonary problems, lower goals and levels of achievement, increased mortality during therapy, fewer amputees who were able to return home, an increased number of aids (cane, crutches, wheelchair), and a longer rehabilitation period. Many patients over age 65 required nearly a year of rehabilitation to achieve maximum benefit.
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In a series of 152 patients aged 65 years or older who underwent abdominal operations between January 1 and December 31, 1971, the total mortality was 17 percent. Pulmonary pathologic conditions were responsible for the majority of the deaths. Use of IPPB did not significantly influence the postoperative course. This study suggests that meticulous preoperative preparation of patients; deliberate, clean, and efficient surgical techniques; and intensive postoperative care are of utmost importance in surgical treatment of the elderly.