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1. Objective: Octogenarians are a rapidly growing population in the US. It is important to understand the effects of age-associated changes in caring for this population. We sought to define the age-associated risks among these patients when undergoing elective or emergent colon procedures.
2. Design: Retrospective cohort study.
3. Setting: Academically-affiliated community hospital.
4. Patients: 500 consecutive colectomy cases (124 octogenarians, 96 emergent) representing 453 patients. Average age: 67.5 (21-98) years old.
5. Interventions: 156 right, 32 left, 113 sigmoid, 13 transverse, 14 total colectomies, 53 LAR, 16 APR, 53 Hartmann’s, 11 colostomy creation, 36 colostomy closure, and 3 rectal.
6. Main Outcome Measures: Deaths, minor (e.g. UTI) or major complications (e.g. anastomotic leak), and rate of emergent procedures.
7. Results: 209 (41.8%) of cases had at least one complication. 46.8% of complications occurred in patients over 80, versus 40.2% among younger patients (p=0.195). 26 patients (5.2%) died, 15 of them octogenarians. The odds of death after a colectomy in octogenarians is 4.57 times that of non-octogenarians (2.038-10.233 p=.000176). 17 patients died undergoing an emergency procedure resulting in an odds ratio of 9.444 (4.064-21.949) when compared to elective procedures. Octogenarians were nearly twice as likely to undergo emergency operations (29.8% vs 25.7% p=.000523). When correcting for confounding, the odds ratio of death was 3.43 for octogenarians and 7.88 for emergency procedures.
8. Conclusions: Octogenarians had a significantly higher mortality rate than younger patients, but they did not have an increased risk of complications. Any patient undergoing an emergent colectomy has a greater chance of death, with the highest risk for an emergency procedure in octogenarians. These data will help in discussing consent before a colectomy.