A RETROSPECTIVE ANALYSIS OF ANESTHETIC APPROACHES IN PATIENTS AGED 85 AND ABOVE

Abstract

OBJECTIVE: Due to the changes that occur with aging, the elderly need more medical support. These medical requirements include surgical operations. In our study, we aimed to examine, improve and compare our anesthetic approaches for people aged 85 and above with the current literature. MATERIAL AND METHODS: A total of 242 patients aged 85 years and above underwent surgery between 01.01.2020 and 01.01.2022 were included in this study. The data of the patients including gender, age, comorbidities, types of anesthesia administered during the surgery, duration of surgery, postoperative ward/intensive care unit (ICU) follow-up periods, intraoperative blood product usage and postoperative mortality were retrospectively analyzed in 3 groups according to the types of anesthesia administered: general, spinal and sedation anesthesia. RESULTS: Of the patients, 130 of the patients were female and 112 were male. The mean age was 87.95±2.57 years. 93.8% of patients had comorbidities. 65.3% of the patients were applied general anesthesia, 29.8% spinal anesthesia and 4.9% sedation anesthesia. While 30.6% of the patients were admitted to ICU after surgery, 69.4% of them were admitted to the ward. While 88% of the patients were discharged with recovery, 12% died in the first 1 month. While 86.2% general anesthesia and 13.8% spinal anesthesia were applied in patients with mortality, 62.4% general anesthesia, 5.6% sedation and 31.4% spinal anesthesia were applied in those without mortality (p=0.036). Mortality was mostly observed in general surgery patients, patients admitted to intensive care unit, and ASA III patients. Mortality was observed more in those who used blood products compared to those who did not (p<0.001). CONCLUSIONS: We think that spinal anesthesia should be preferred in appropriate elderly patients and more caution should be exercised in indications for blood product use and postoperative intensive care unit admission.