Abstract

INTRODUCTION

Operations on ASA III-IV graded patients are increasing due to the increase in geriatric population with multiple morbidities. Aim of this study is to evaluate the effects of the type of anesthesia on postoperative complications and mortality in geriatric patients with ASA III-IV score.

METHODS

The data of 605 patients graded as ASA III-IV and aged 65 years and older,who underwent elective surgery between January 2010 and December 2015, were retrospectively analyzed. Patients were divided into two groups as general anesthesia (GA) and regional anesthesia (RA). Age, gender, ASA score, grade of surgical operation, presence of intensive care unit follow-up, postoperative complications and mortality were recorded in all patients. Statistical analysis was performed to compare the factors affecting mortality and complications with RA and GA methods.

RESULTS

The mean age of 605 patients, who were included in the study, was 76.41 ( min 65, max 98 years old). 378 of the patients (62,5%) were performed regional anesthesia and 227 (37,5%) of them were performed general anesthesia. Mortality was seen in 33 patients (5,5%). In RA group mortality was seen in 13 patients (3,4%) and in GA group it was seen in 20 patients (8,8%). Postoperative complications were seen in 111 (18,3%) patients. Most commonly, respiratory failure was seen in 19 patients (3,1%) and delirium was seen in 17 ( 2,8% )patients. Mean duration of hospital stay was 5.13 ± 6.2 days in RA group and 7.1 ± 6.3 days in GA group. 61 (16.1%) patients in RA group and 87 (38.3%) patients in GA group required postoperative intensive care unit follow-up.

DISCUSSION AND CONCLUSION

RA has positive effects in decreasing the postoperative respiratory complications, need of intensive care monitoring and hospital stay duration. We think that in geriatric patients RA is more advantageous compared to GA in terms of mortality and postoperative complications.