Effects of age and severity of illness on outcome and length of stay in geriatric surgical patients

Am J Surg. 1993 May;165(5):577-80. doi: 10.1016/s0002-9610(05)80438-6.


From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on admission and in-hospital morbidity. All patients were followed up until death or discharge from the hospital. Using the hospital database, we analyzed the patient sample to test the hypothesis that severity of illness was more important than age in predicting postoperative morbidity and mortality rates. Using correlation and multiple regression analysis, we found that the severity of illness was a much better predictor of outcome than age. The results were significant at the level of p < 0.001. Based on the results of this study, we recommend that age not be used in surgical decisions in the elderly.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • British Columbia / epidemiology
  • Follow-Up Studies
  • Geriatric Assessment*
  • Hospital Bed Capacity, 500 and over
  • Hospital Mortality
  • Hospitals, Community / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data*
  • Outcome Assessment, Health Care*
  • Patient Admission
  • Regression Analysis
  • Severity of Illness Index*
  • Surgical Procedures, Operative / mortality*
  • Survival Analysis