Canadian Journal of Anesthesia, Vol 12, 510-520, Copyright © 1965 by Canadian Anesthesiologists' Society

Factors Affecting Survival of the Geriatric Patient after Major Surgery

¹ Departments of Anaesthesia and Surgery, Université de Montréal, and Notre-Dame Hospital, Montréal, Canada

We have reviewed the incidence of major surgery in geriatric patients in our hospital There were 313 such operations performed in 1963 and 1964, with an over–all mortality of 13 per cent Less than one per cent of all operations and only about 15 per cent of the geriatric surgery satisfied our criteria, yet these patients accounted for 10 per cent of our surgical and for 45 per cent of our geriatric surgical mortality.

Among the various factors investigated, the site of surgery and operating time were found not to contribute significantly to mortality The age of our subjects had some effect, and the time available for pre–operative therapy had a marked effect.

Anaesthetic agents had no effect on mortality at first sight, but when the choice of different agents was taken into account a statistically significant nega–tive correlation emerged between mortality and the use of neuroleptanalgesia This observation is tentatively explained by the fact that NLA makes it possible to assist the respiration of most elderly patients for some time after surgery The rationale for this treatment and our procedure are discussed m some detail.

Note:

Parts of this study were presented by the senior author (M K-Sz) in a panel discussion of neuroleptanalgesia at the Third World Congress of Anaesthesiologists, Sao Paulo, September 1964, and before the Annual Meeting of the Royal College of Physicians and Surgeons of Canada, Toronto, January 1965