The explanation for these surprising findings is unknown, but the possibilities may include a tendency by physicians to avoid surgery in frail elderly patients and, conversely, a "hardy survivor" effect, in which a protective genetic makeup may enable elderly patients to withstand the rigors of surgery and its complications.
Keith S. Kaye, MD, MPH, and colleagues at Duke University Medical Center and Durham Veterans Affairs Medical Center studied 144,485 patients over age 16 years with no pre-existing surgical-site infections who were admitted for surgery to 11 hospitals in the southeastern United States between Feb. 1, 1991 and July 31, 2002; the most common surgical procedures were orthopedic (42 percent), gastrointestinal (13 percent), obstetric/gynecologic (11 percent), or cardiothoracic (10 percent). Of the 144,485 patients studied, surgical-site infections developed in 1,684 (1.2 percent), with gastrointestinal procedures (3.1 percent), cardiothoracic procedures (2.3 percent), and vascular procedures (1.7 percent) having the highest rates
Between ages 17 and 65 years, the infection rate increased for each decade of increasing age, peaked at ages 65 to 74, and then decreased for each subsequent decade. This "inverted V" pattern was also seen when the investigators randomly divided the patients into two groups so that ag
Contact: Steve Baragona
Infectious Diseases Society of America