The elderly population in the United States is expected to rise from 34.7 million in 2000 to 69.4 million persons older than 65 years in 2030, according to background information in the article. This may result in increased numbers of elderly patients requiring major head and neck surgical procedures. As age has received increased attention as a predictive factor for postoperative complications, so has the question of the appropriateness of candidates for surgery based on age.

Marina Boruk, M.D., from the State University of New York Downstate Medical Center, Brooklyn, and colleagues, conducted a retrospective study of medical records, between January 1999 and January 2004, to determine if age alone is a predictor of outcomes for major head and neck surgery. The review included 157 cases of patients who had undergone a major head and neck surgical procedure, of whom 31 (20 percent) were 70 years or older. The age of patients ranged from nine to 95 years, with an average of 56.1 years. Fifty-nine percent (92) were men and 41 percent (65) were women.

Patient's age alone was not found to be a predictive indicator of outcomes for major head and neck surgery. Time under general anesthesia (TUGA) was the only factor found to be consistently related to surgical complications and length of hospital stay. TUGA ranged from 75 to 1,160 minutes, with a median (middle value) of 240 minutes. The odds of a patient having a complication increased by 0.6 percent with every minute of anesthesia, therefore the odds of having a major complication increased by 36 percent every hour under anesthesia. The odds of having any complication (major or minor) increased by 18 to 3
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JAMA and Archives Journals
18-Jul-2005