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The Impact of the Aging Population on Surgical Diseases

  • Surgical Care (F Luchette, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The portion of the population comprised by those aged 65 years and older is the fastest growing age group. With the aging of Americans, so goes the age of a surgeon’s patients. It is also well established that with aging, the incidence of various diseases also increases. Thus, more surgical care will be consumed by the elderly. The cost of care however will be greater for geriatric patients when compared to younger patients due to the greater incidence of comorbidities in the elderly. The surgical community will need to develop new protocols for the perioperative care of these frail patients in order to provide safe care with acceptable morbidity and mortality rates.

Recent Findings

Over the past 5 years, there have been notable changes in the surgical management of geriatric patients. Increased evidence in several surgical specialties supports that minimally invasive techniques for traditional open procedures improve outcomes. Additional knowledge regarding the effect of aging on organ function has led to improved stratification and preoperative preparation of patients prior to surgery. An example of this is the establishment of specific triage criteria for geriatric trauma patients. These changes have resulted in reduced morbidity and mortality rates.

Summary

The elderly form a large portion of surgical patients, and this portion will continue to grow as life expectancy improves. Surgeons must adapt to this changing environment to provide optimal care to geriatric patients.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bureau USC. Projections of the Size and Composition of the U.S. Population: 2014 to 2060. 2015.

  2. Services USDoHaH. Mortality in the United States, 2018. NCHS Data Brief. 2020;355.

  3. Services USDoHaH. Hospitalizations for patients aged 85 and over in the United States, 2000-2010. NCHS Data Brief 2015;182.

  4. Ellison EC, Pawlik TM, Way DP, Satiani B, Williams TE. The impact of the aging population and incidence of cancer on future projections of general surgical workforce needs. Surg. 2018;163(3):553–9. https://doi.org/10.1016/j.surg.2017.09.035Describes increasing rates of cancer patients, the projected shortages of surgeons, and proposed ideas to address the care deficits.

    Article  Google Scholar 

  5. Colleges AoAM. The complexities of physician supply and demand: projections from 2018 to 2033. 2020.

    Google Scholar 

  6. Project HCaU. Trends in hospital inpatient stays by age and payer, 2000-2015. Statistical Brief. 2018(235).

  7. Project HCaU. Trends in Hospital Inpatient Stays in the United States, 2005-2014. Statistical Brief 2017.

  8. Chow WB, Rosenthal RA, Merkow RP, Ko CY, Esnaola NF, American College of Surgeons National Surgical Quality Improvement P, et al. Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg. 2012;215(4):453–66. https://doi.org/10.1016/j.jamcollsurg.2012.06.017.

    Article  PubMed  Google Scholar 

  9. Kirkhus L, Benth JS, Gronberg BH, Hjermstad MJ, Rostoft S, Harneshaug M, et al. Frailty identified by geriatric assessment is associated with poor functioning, high symptom burden and increased risk of physical decline in older cancer patients: prospective observational study. Palliat Med. 2019;33(3):312–22.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Maxwell CA, Patel MB, Suarez-Rodriguez LC, Miller RS. Frailty and prognostication in geriatric surgery and trauma. Clin Geriatr Med. 2019;35(1):13–26. https://doi.org/10.1016/j.cger.2018.08.002Provides definition of frailty, models used for patient evaluation, and its role in trauma and surgery.

    Article  PubMed  Google Scholar 

  11. Richards SJG, Frizelle FA, Geddes JA, Eglinton TW, Hampton MB. Frailty in surgical patients. Int J Color Dis. 2018;33(12):1657–66. https://doi.org/10.1007/s00384-018-3163-y.

    Article  Google Scholar 

  12. Andreou A, Lasithiotakis K, Venianaki M, Xenaki S, Chlouverakis G, Petrakis I, et al. A comparison of two preoperative frailty models in predicting postoperative outcomes in geriatric general surgical patients. World J Surg. 2018;42(12):3897–902. https://doi.org/10.1007/s00268-018-4734-3.

    Article  PubMed  Google Scholar 

  13. Hanna K, Ditillo M, Joseph B. The role of frailty and prehabilitation in surgery. Curr Opin Crit Care. 2019;25(6):717–22. https://doi.org/10.1097/MCC.0000000000000669.

    Article  PubMed  Google Scholar 

  14. Hughes MJ, Hackney RJ, Lamb PJ, Wigmore SJ, Christopher Deans DA, Skipworth RJE. Prehabilitation before major abdominal surgery: a systematic review and meta-analysis. World J Surg. 2019;43(7):1661–8. https://doi.org/10.1007/s00268-019-04950-yMeta-analysis demonstrating that prehabilitation programs prior to surgery result in decreased morbidity postoperatively.

    Article  PubMed  Google Scholar 

  15. Janssen TL, Steyerberg EW, van Hoof-de Lepper C, Seerden TCJ, de Lange DC, Wijsman JH, et al. Long-term outcomes of major abdominal surgery and postoperative delirium after multimodal prehabilitation of older patients. Surg Today. 2020;50:1461–70. https://doi.org/10.1007/s00595-020-02044-0.

    Article  PubMed  Google Scholar 

  16. Katz M, Silverstein N, Coll P, Sullivan G, Girard E, Sachs A, et al. Surgical care of the geriatric patient. Curr Probl Surg. 2019;56(7):260–329. https://doi.org/10.1067/j.cpsurg.2019.03.003Describes physiologic changes with increased age and their influence on the surgical care. Analyzes the role that increased age has on different surgical specialties.

    Article  PubMed  Google Scholar 

  17. Mohanty S, Rosenthal RA, Russell MM, Neuman MD, Ko CY, Esnaola NF. Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016;222(5):930–47. https://doi.org/10.1016/j.jamcollsurg.2015.12.026.

    Article  PubMed  Google Scholar 

  18. Lester L. Anesthetic considerations for common procedures in geriatric patients: hip fracture, emergency general surgery, and transcatheter aortic valve replacement. Anesthesiol Clin. 2015;33(3):491–503. https://doi.org/10.1016/j.anclin.2015.05.006.

    Article  PubMed  Google Scholar 

  19. Saljuqi AT, Hanna K, Asmar S, Tang A, Zeeshan M, Gries L, et al. Prospective evaluation of delirium in geriatric patients undergoing emergency general surgery. J Am Coll Surg. 2020;230(5):758–65. https://doi.org/10.1016/j.jamcollsurg.2020.01.029Demonstrates patients with preoperative cognitive impairment have significantly higher rates of complications, mortality, and readmissions.

    Article  PubMed  Google Scholar 

  20. Joyce MF, Reich JA. Critical care issues of the geriatric patient. Anesthesiol Clin. 2015;33(3):551–61. https://doi.org/10.1016/j.anclin.2015.05.009.

    Article  PubMed  Google Scholar 

  21. Sucher JF, Mangram AJ, Dzandu JK. Utilization of geriatric consultation and team-based care. Clin Geriatr Med. 2019;35(1):27–33. https://doi.org/10.1016/j.cger.2018.08.003Multidisciplinary care and collaboration when caring for geriatric trauma patients leads to improved care provided.

    Article  PubMed  Google Scholar 

  22. Howie S, Tinker A. Are we on the same page? Exploring the role of the geriatrician in the care of the older surgical patient from the perspective of surgeons and geriatricians. Clin Med. 2018;18(5):374–9.

    Article  Google Scholar 

  23. Southerland LT, Gure TR, Ruter DI, Li MM, Evans DC. Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines. J Surg Res. 2017;216:56–64. https://doi.org/10.1016/j.jss.2017.03.023.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Desserud KF, Veen T, Soreide K. Emergency general surgery in the geriatric patient. Br J Surg. 2016;103(2):e52–61. https://doi.org/10.1002/bjs.10044.

    Article  CAS  PubMed  Google Scholar 

  25. Lyu HG, Najjar P, Havens JM. Past, present, and future of emergency general surgery in the USA. Acute Med Surg. 2018;5(2):119–22. https://doi.org/10.1002/ams2.327.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, et al. Use of national burden to define operative emergency general surgery. JAMA Surg. 2016;151:e160480.

    Article  PubMed  Google Scholar 

  27. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132(5):910–25. https://doi.org/10.1093/oxfordjournals.aje.a115734.

    Article  CAS  PubMed  Google Scholar 

  28. Singh JP, Mariadason JG. Role of the faecolith in modern-day appendicitis. Ann R Coll Surg Engl. 2013;95(1):48–51. https://doi.org/10.1308/003588413X13511609954851.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterol. 2009;136(3):741–54. https://doi.org/10.1053/j.gastro.2009.01.015.

    Article  Google Scholar 

  30. Livingston EH, Woodward WA, Sarosi GA, Haley RW. Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management. Ann Surg. 2007;245(6):886–92. https://doi.org/10.1097/01.sla.0000256391.05233.aa.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Loftus TJ, Raymond SL, Sarosi GA Jr, Croft CA, Smith RS, Efron PA, et al. Predicting appendiceal tumors among patients with appendicitis. J Trauma Acute Care Surg. 2017;82(4):771–5. https://doi.org/10.1097/TA.0000000000001378.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Collaborative C, Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, et al. A randomized trial comparing antibiotics with appendectomy for appendicitis. N Engl J Med. 2020;383(20):1907–19. https://doi.org/10.1056/NEJMoa2014320Randomized trial demonstrated antibiotics are non-inferior to surgery in the treatment of appendicitis.

    Article  Google Scholar 

  33. Styrud J, Eriksson S, Nilsson I, Ahlberg G, Haapaniemi S, Neovius G, et al. Appendectomy versus antibiotic treatment in acute appendicitis. A prospective multicenter randomized controlled trial. World J Surg. 2006;30(6):1033–7. https://doi.org/10.1007/s00268-005-0304-6.

    Article  PubMed  Google Scholar 

  34. Salminen P, Tuominen R, Paajanen H, Rautio T, Nordstrom P, Aarnio M, et al. Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial. JAMA. 2018;320(12):1259–65. https://doi.org/10.1001/jama.2018.13201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Attili AF, Carulli N, Roda E, Barbara B, Capocaccia L, Menotti A, et al. Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL.). Am J Epidemiol. 1995;141(2):158–65. https://doi.org/10.1093/oxfordjournals.aje.a117403.

    Article  CAS  PubMed  Google Scholar 

  36. Cull JD, Velasco JM, Czubak A, Rice D, Brown EC. Management of acute cholecystitis: prevalence of percutaneous cholecystostomy and delayed cholecystectomy in the elderly. J Gastrointest Surg. 2014;18(2):328–33. https://doi.org/10.1007/s11605-013-2341-z.

    Article  PubMed  Google Scholar 

  37. Bergman S, Sourial N, Vedel I, Hanna WC, Fraser SA, Newman D, et al. Gallstone disease in the elderly: are older patients managed differently? Surg Endosc. 2011;25(1):55–61. https://doi.org/10.1007/s00464-010-1128-5.

    Article  PubMed  Google Scholar 

  38. Garces-Albir M, Martin-Gorgojo V, Perdomo R, Molina-Rodriguez JL, Munoz-Forner E, Dorcaratto D, et al. Acute cholecystitis in elderly and high-risk surgical patients: is percutaneous cholecystostomy preferable to emergency cholecystectomy? J Gastrointest Surg. 2019;24:2579–86. https://doi.org/10.1007/s11605-019-04424-5.

    Article  PubMed  Google Scholar 

  39. Park CS, Jeong HS, Kim KB, Han JH, Chae HB, Youn SJ, et al. Urgent ERCP for acute cholangitis reduces mortality and hospital stay in elderly and very elderly patients. Hepatobiliary Pancreat Dis Int. 2016;15(6):619–25. https://doi.org/10.1016/s1499-3872(16)60130-3.

    Article  PubMed  Google Scholar 

  40. Malik AM. Biliary pancreatitis. Deadly threat to the elderly. Is it a real threat? Int J Health Sci (Qassim). 2015;9(1):35–9. https://doi.org/10.12816/0024681.

    Article  Google Scholar 

  41. Kirkegard J, Horn T, Christensen SD, Larsen LP, Knudsen AR, Mortensen FV. Percutaneous cholecystostomy is an effective definitive treatment option for acute acalculous cholecystitis. Scand J Surg. 2015;104(4):238–43. https://doi.org/10.1177/1457496914564107.

    Article  CAS  PubMed  Google Scholar 

  42. Stumpf M, Cao W, Klinge U, Klosterhalfen B, Kasperk R, Schumpelik V. Increased distribution of collagen type II and reduced expression of matrix metalloproteinase I in patients with diverticular disease. Int J Color Dis. 2001;16:271–5. https://doi.org/10.1007/s003840100310.

    Article  CAS  Google Scholar 

  43. Feuerstein JD, Falchuk KR. Diverticulosis and diverticulitis. Mayo Clin Proc. 2016;91(8):1094–104. https://doi.org/10.1016/j.mayocp.2016.03.012.

    Article  PubMed  Google Scholar 

  44. Ogola GO, Shafi S. Cost of specific emergency general surgery diseases and factors associated with high-cost patients. J Trauma Acute Care Surg. 2016;80(2):265–71. https://doi.org/10.1097/TA.0000000000000911.

    Article  PubMed  Google Scholar 

  45. Ozturk E, van Iersel M, Stommel MM, Schoon Y, Ten Broek RR, van Goor H. Small bowel obstruction in the elderly: a plea for comprehensive acute geriatric care. World J Emerg Surg. 2018;13:48. https://doi.org/10.1186/s13017-018-0208-zDescribes the causes of small bowel obstruction in the elderly and current approaches. Prompts future study into the outcomes in elderly patients.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Halabi WJ, Jafari MD, Kang CY, Nguyen VQ, Carmichael JC, Mills S, et al. Colonic volvulus in the United States: trends, outcomes, and predictors of mortality. Ann Surg. 2014;259(2):293–301. https://doi.org/10.1097/SLA.0b013e31828c88ac.

    Article  PubMed  Google Scholar 

  47. Luchette FA, Yelon JA. Geriatric trauma and critical care. 2017. Textbook describing the different facets involved in geriatric care.

    Book  Google Scholar 

  48. Krause WR, Webb TP. Geriatric small bowel obstruction: an analysis of treatment and outcomes compared with a younger cohort. Am J Surg. 2015;209(2):347–51. https://doi.org/10.1016/j.amjsurg.2014.04.008.

    Article  PubMed  Google Scholar 

  49. Fallah MA, Prakash C, Edmundowicz S. Acute gastrointestinal bleeding. Med Clin North Am. 2000;84(5):1183–208. https://doi.org/10.1016/s0025-7125(05)70282-0.

    Article  CAS  PubMed  Google Scholar 

  50. Jafri SM, Monkemuller K, Lukens FJ. Endoscopy in the elderly: a review of the efficacy and safety of colonoscopy, esophagogastroduodenoscopy, and endoscopic retrograde cholangiopancreatography. J Clin Gastroenterol. 2010;44(3):161–6. https://doi.org/10.1097/MCG.0b013e3181c64d64.

    Article  PubMed  Google Scholar 

  51. El-Tawil AM. Trends on gastrointestinal bleeding and mortality: where are we standing? World J Gastroenterol. 2012;18(11):1154–8. https://doi.org/10.3748/wjg.v18.i11.1154.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Sharma M, Cornelius VR, Patel JP, Davies JG, Molokhia M. Efficacy and harms of direct oral anticoagulants in the elderly for stroke prevention in atrial fibrillation and secondary prevention of venous thromboembolism: systematic review and meta-analysis. Circulation. 2015;132(3):194–204. https://doi.org/10.1161/CIRCULATIONAHA.114.013267.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Tazarourte K, Riou B, Tremey B, Samama CM, Vicaut E, Vigue B, et al. Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study). Crit Care. 2014;18(2):R81. https://doi.org/10.1186/cc13843.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Karaca MA, Erbil B, Ozmen MM. Use and effectiveness of prothrombin complex concentrates vs fresh frozen plasma in gastrointestinal hemorrhage due to warfarin usage in the ED. Am J Emerg Med. 2014;32(6):660–4. https://doi.org/10.1016/j.ajem.2014.02.016.

    Article  PubMed  Google Scholar 

  55. Committee ASoP, Chandrasekhara V, Early DS, Acosta RD, Chathadi KV, Decker GA, et al. Modifications in endoscopic practice for the elderly. Gastrointest Endosc. 2013;78(1):1–7. https://doi.org/10.1016/j.gie.2013.04.161.

    Article  Google Scholar 

  56. Wu JJ, Baldwin BC, Goldwater E, Counihan TC. Should we perform elective inguinal hernia repair in the elderly? Hernia. 2017;21(1):51–7. https://doi.org/10.1007/s10029-016-1517-3.

    Article  CAS  PubMed  Google Scholar 

  57. Elhage SA, Shao JM, Deerenberg EB, Prasad T, Colavita PD, Kercher KW, et al. Laparoscopic ventral hernia repair in the geriatric population: an assessment of long-term outcomes and quality of life. Am Surg. 2020;86(8):1015–21. https://doi.org/10.1177/0003134820942149Laparoscopic repair has equal outcomes and leads to improved quality of life amongst geriatric patients.

    Article  PubMed  Google Scholar 

  58. Bates AT, Divino C. Laparoscopic surgery in the elderly: a review of the literature. Aging Dis. 2015;6(2):149–55. https://doi.org/10.14336/AD.2014.0429.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Vu JV, Gunaseelan V, Dimick JB, Englesbe MJ, Campbell DA Jr, Telem DA. Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair. Surg Endosc. 2019;33(12):4032–7. https://doi.org/10.1007/s00464-019-06695-0Provides evidence that elderly patients are less likely to be offered minimally invasive surgical hernia repair.

    Article  PubMed  PubMed Central  Google Scholar 

  60. HerniaSurge G. International guidelines for groin hernia management. Hernia. 2018;22(1):1–165. https://doi.org/10.1007/s10029-017-1668-x.

    Article  Google Scholar 

  61. Balentine CJ, Meier J, Berger M, Reisch J, Cullum M, Lee SC, et al. Using local anesthesia for inguinal hernia repair reduces complications in older patients. J Surg Res. 2021;258:64–72. https://doi.org/10.1016/j.jss.2020.08.054.

    Article  PubMed  Google Scholar 

  62. Becher RD, DeWane MP, Sukumar N, Stolar MJ, Gill TM, Becher RM, et al. Hospital operative volume as a quality indicator for general surgery operations performed emergently in geriatric patients. J Am Coll Surg. 2019;228(6):910–23. https://doi.org/10.1016/j.jamcollsurg.2019.02.053Hospitals with higher operative volume demonstrated improved survival in surgical geriatric patients.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Mastalerz K, Kenig J, Skorus U. Intraoperative factors Influening postoperative outcomes in older patients undergoing abdominal surgery - narrative review. Indian J of Surg. 2018;80(6):609–15.

    Article  Google Scholar 

  64. Martin AN, Hoagland DL, Turrentine FE, Jones RS, Zaydfudim VM. Safety of major abdominal operations in the elderly: a study of geriatric-specific determinants of health. World J Surg. 2020;44(8):2592–600. https://doi.org/10.1007/s00268-020-05515-0.

    Article  PubMed  Google Scholar 

  65. Kolarsick PA, Sacchi M, Spinelli A, Wexner SD. Minimizing the impact of colorectal surgery in the older patient: the role of minimally invasive surgery in the geriatric population. Eur J Surg Oncol. 2020;46(3):333–7. https://doi.org/10.1016/j.ejso.2019.12.019.

    Article  PubMed  Google Scholar 

  66. Duraes LC, Stocchi L, Dietz D, Kalady MF, Kessler H, Schroeder D, et al. The disproportionate effect of perioperative complications on mortality within 1 year after colorectal cancer resection in octogenarians. Ann Surg Oncol. 2016;23(13):4293–301. https://doi.org/10.1245/s10434-016-5445-3.

    Article  PubMed  Google Scholar 

  67. Zhao X, Yang Y, Gu H, Zhou W, Zhang Q. New prognostic risk score for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer surgery: U.S. Nationwide Inpatient Sample analysis. J Geriatr Oncol. 2020;11(8):1250–4. https://doi.org/10.1016/j.jgo.2020.04.003.

    Article  PubMed  Google Scholar 

  68. Force USPST. Colorectal Cancer: screening. 2016. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Accessed 18 Oct 2020.

  69. Chan TY, Foo CC, Law WL, Lo O. Outcomes of colorectal cancer surgery in the nonagenarians: 20-year result from a tertiary center. BMC Surg. 2019;19(1):155. https://doi.org/10.1186/s12893-019-0623-4.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Dworsky JQ, Childers CP, Maggard-Gibbons M, Russell MM. High-risk colorectal surgery: what are the outcomes for geriatric patients? Am Surg. 2018;84(10):1650–4.

    Article  PubMed  Google Scholar 

  71. Hinoi T, Kawaguchi Y, Hattori M, Okajima M, Ohdan H, Yamamoto S, et al. Laparoscopic versus open surgery for colorectal cancer in elderly patients: a multicenter matched case-control study. Ann Surg Oncol. 2015;22(6):2040–50. https://doi.org/10.1245/s10434-014-4172-x.

    Article  PubMed  Google Scholar 

  72. Wang X, Zhao J, Fairweather M, Yang T, Sun Y, Wang J. Optimal treatment for elderly patients with resectable proximal gastric carcinoma: a real world study based on National Cancer Database. BMC Cancer. 2019;19(1):1079. https://doi.org/10.1186/s12885-019-6166-3Surgical resection of gastric cancer results in improved outcomes. Geriatric patients are less likely to be referred for surgical resection and have improved survival when surgery is performed at academic medical centers.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Takeshita H, Ichikawa D, Komatsu S, Kubota T, Okamoto K, Shiozaki A, et al. Surgical outcomes of gastrectomy for elderly patients with gastric cancer. World J Surg. 2013;37(12):2891–8. https://doi.org/10.1007/s00268-013-2210-7.

    Article  PubMed  Google Scholar 

  74. Wakahara T, Ueno N, Maeda T, Kanemitsu K, Yoshikawa T, Tsuchida S, et al. Postoperative morbidity in elderly patients after gastric cancer surgery. Ann Gastroenterol. 2018;31(5):621–7. https://doi.org/10.20524/aog.2018.0274.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Zhao G, Cao XL, Yu T, An Q, Yang H, Xiao G. Treatment selection for gastric cancer in extremely elderly patients. Chin Med J. 2018;131(17):2122–4. https://doi.org/10.4103/0366-6999.239313.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Macedo FIB, Jayanthi P, Mowzoon M, Yakoub D, Dudeja V, Merchant N. The impact of surgeon volume on outcomes after pancreaticoduodenectomy: a meta-analysis. J Gastrointest Surg. 2017;21(10):1723–31. https://doi.org/10.1007/s11605-017-3498-7.

    Article  PubMed  Google Scholar 

  77. van der Geest LG, Besselink MG, Busch OR, de Hingh IH, van Eijck CH, Dejong CH, et al. Elderly patients strongly benefit from centralization of pancreatic cancer surgery: a population-based study. Ann Surg Oncol. 2016;23(6):2002–9. https://doi.org/10.1245/s10434-016-5089-3.

    Article  PubMed  Google Scholar 

  78. Tan E, Song J, Lam S, D'Souza M, Crawford M, Sandroussi C. Postoperative outcomes in elderly patients undergoing pancreatic resection for pancreatic adenocarcinoma: a systematic review and meta-analysis. Int J Surg. 2019;72:59–68. https://doi.org/10.1016/j.ijsu.2019.09.030Demonstrated the differences in treatment of pancreatic cancer amongst elderly patients and concluded that age alone should not be a deterrent when deciding whether to operate.

    Article  PubMed  Google Scholar 

  79. Mizrahi JD, Surana R, Valle JW, Shroff RT. Pancreatic cancer. Lancet. 2020;395(10242):2008–20. https://doi.org/10.1016/S0140-6736(20)30974-0Comprehensive review on current pancreatic cancer treatment, including the role of surgical resection.

    Article  CAS  PubMed  Google Scholar 

  80. Higuera O, Ghanem I, Nasimi R, Prieto I, Koren L, Feliu J. Management of pancreatic cancer in the elderly. World J Gastroenterol. 2016;22(2):764–75. https://doi.org/10.3748/wjg.v22.i2.764.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Horgan A, Knox J, Aneja P, Le L, McKeever E, McNamara M. Patterns of care and treatment outcomes in older patients with biliary tract cancer. Oncotarget. 2015;6(42):44995–5004. https://doi.org/10.18632/oncotarget.5707.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Kaibori M, Ishizaki M, Matsui K, Iida H, Inoue K, Nagashima F, et al. Geriatric assessment as a predictor of postoperative complications in elderly patients with hepatocellular carcinoma. Langenbeck's Arch Surg. 2016;401(2):205–14. https://doi.org/10.1007/s00423-016-1388-1.

    Article  Google Scholar 

  83. Yu X, Yan YC, Chen G, Yu H. The efficacy and safety of totally laparoscopic hepatectomy for non-cirrhotic hepatocellular carcinoma in the elderly. BMC Surg. 2018;18(1):118. https://doi.org/10.1186/s12893-018-0444-xShowed comparable outcomes amongst young and elderly patients when undergoing laparoscopic hepatectomy.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Sahara K, Paredes AZ, Tsilimigras DI, Hyer JM, Merath K, Wu L, et al. Impact of liver cirrhosis on perioperative outcomes among elderly patients undergoing hepatectomy: the effect of minimally invasive surgery. J Gastrointest Surg. 2019;23(12):2346–53. https://doi.org/10.1007/s11605-019-04117-z.

    Article  PubMed  Google Scholar 

  85. Hamaoka M, Kobayashi T, Ishiyama K, Ohira M, Tahara H, Kuroda S, et al. Evaluation of the risk factors and prognostic factors of hepatectomy for hepatocellular carcinoma in patients aged 80 years or more. J Hepatobiliary Pancreat Sci. 2017;24(1):58–64. https://doi.org/10.1002/jhbp.413.

    Article  PubMed  Google Scholar 

  86. Cauchy F, Fuks D, Nomi T, Dokmak S, Scatton O, Schwarz L, et al. Benefits of laparoscopy in elderly patients requiring major liver resection. J Am Coll Surg. 2016;222(2):174–84 e10. https://doi.org/10.1016/j.jamcollsurg.2015.11.006.

    Article  PubMed  Google Scholar 

  87. Reske-Nielsen C, Medzon R. Geriatric trauma. Emerg Med Clin North Am. 2016;34(3):483–500. https://doi.org/10.1016/j.emc.2016.04.004.

    Article  PubMed  Google Scholar 

  88. Chang M. National Trauma Data Base Annual Repot 2016: American College of Surgeons 2016.

  89. Atinga A, Shekkeris A, Fertleman M, Batrick N, Kashef E, Dick E. Trauma in the elderly patient. Br J Radiol. 2018;91(1087):20170739. https://doi.org/10.1259/bjr.20170739Describes the common injuries and treatment changes amongst elderly trauma patients.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Wang H, Phillips JL, Robinson RD, Duane TM, Buca S, Campbell-Furtick MB, et al. Predictors of mortality among initially stable adult pelvic trauma patients in the US: data analysis from the National Trauma Data Bank. Injury. 2015;46(11):2113–7. https://doi.org/10.1016/j.injury.2015.08.039.

    Article  PubMed  Google Scholar 

  91. Bennett A, Li H, Patel A, Kang K, Gupta P, Choueka J, et al. Retrospective analysis of geriatric patients undergoing hip fracture surgery: delaying surgery is associated with increased morbidity, mortality, and length of stay. Geriatr Orthop Surg Rehabil. 2018;9:2151459318795260. https://doi.org/10.1177/2151459318795260.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Fagon JY. Acute respiratory failure in the elderly. Crit Care. 2006;10(4):151. https://doi.org/10.1186/cc4982.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Wearn CM, Hardwicke J, Moiemen N. Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre. Burns. 2015;41(6):1161–8. https://doi.org/10.1016/j.burns.2015.08.029.

    Article  PubMed  Google Scholar 

  94. Abu-Sittah GS, Chahine FM, Janom H. Management of burns in the elderly. Ann Burns Fire Disast. 2016;29(4):249–5.

    CAS  Google Scholar 

  95. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the baux score. J Trauma. 2010;68(3):690–7. https://doi.org/10.1097/TA.0b013e3181c453b3.

    Article  PubMed  Google Scholar 

  96. Saffle JI. The phenomenon of “fluid creep” in acute burn resuscitation. J Burn Care Res. 2007;28(3):382–95. https://doi.org/10.1097/BCR.0B013E318053D3A1.

    Article  PubMed  Google Scholar 

  97. Powers JG, Higham C, Broussard K, Phillips TJ. Wound healing and treating wounds: chronic wound care and management. J Am Acad Dermatol. 2016;74(4):607–25; quiz 25-6. https://doi.org/10.1016/j.jaad.2015.08.070.

    Article  PubMed  Google Scholar 

  98. Sharp CA, Schulz Moore JS, McLaws ML. Two-hourly repositioning for prevention of pressure ulcers in the elderly: patient safety or elder abuse? J Bioeth Inq. 2019;16(1):17–34. https://doi.org/10.1007/s11673-018-9892-3.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Palese A, Trevisani B, Guarnier A, Barelli P, Zambiasi P, Allegrini E, et al. Prevalence and incidence density of unavoidable pressure ulcers in elderly patients admitted to medical units. J Tissue Viabil. 2017;26(2):85–8. https://doi.org/10.1016/j.jtv.2017.03.003.

    Article  Google Scholar 

  100. 2019 Plastic Surgery Statistics. The American Society of Plastic Surgeons. 2019.

  101. Gerth DJ. Structural and volumetric changes in the aging face. Facial Plast Surg. 2015;31:3–9.

    Article  CAS  PubMed  Google Scholar 

  102. Newberry I, Cerrati EW, Thomas JR. Facial plastic surgery in the geriatric population. Otolaryngol Clin N Am. 2018;51(4):789–802. https://doi.org/10.1016/j.otc.2018.03.013Describes the role of aging as it relates to facial surgery, and the approach changes surgeons should incorporate.

    Article  Google Scholar 

  103. Cotofana S, Fratila AA, Schenck TL, Redka-Swoboda W, Zilinsky I, Pavicic T. The anatomy of the aging face: a review. Facial Plast Surg. 2016;32(3):253–60. https://doi.org/10.1055/s-0036-1582234.

    Article  CAS  PubMed  Google Scholar 

  104. Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthet Plast Surg. 2012;36(4):753–60. https://doi.org/10.1007/s00266-012-9904-3.

    Article  Google Scholar 

  105. Dreher R, Blaya C, Tenorio JL, Saltz R, Ely PB, Ferrao YA. Quality of life and aesthetic plastic surgery: a systematic review and meta-analysis. Plast Reconstr Surg Glob Open. 2016;4(9):e862. https://doi.org/10.1097/GOX.0000000000000833.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Spadoni-Pacheco L, Carvalho G. Quality of life and self-esteem in elderly patients who did or did not have cosmetic surgery. Rev Bras Cir Plast. 2001;33:528–35.

    Google Scholar 

  107. Becker FF, Castellano RD. Safety of face-lifts in the older patient. Arch Facial Plast Surg. 2004;6(5):311–4. https://doi.org/10.1001/archfaci.6.5.311.

    Article  PubMed  Google Scholar 

  108. Partridge JS, Harari D, Martin FC, Peacock JL, Bell R, Mohammed A. Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery. J Vasc Surg. 2017;65(6):679–87. https://doi.org/10.1016/j.jvs.2017.04.003.

    Article  Google Scholar 

  109. Erben Y, Mena-Hurtado CI, Miller SM, Jean RA, Sumpio BJ, Velasquez CA, et al. Increased mortality in octogenarians treated for lifestyle limiting claudication. Catheter Cardiovasc Interv. 2018;91(7):1331–8. https://doi.org/10.1002/ccd.27523Demonstrates shift to majority endovascular interventions for claudication, and higher mortality with increased age.

    Article  PubMed  Google Scholar 

  110. Raval MV, Eskandari MK. Outcomes of elective abdominal aortic aneurysm repair among the elderly: endovascular versus open repair. Surg. 2012;151(2):245–60. https://doi.org/10.1016/j.surg.2010.10.022.

    Article  Google Scholar 

  111. Locham S, Lee R, Nejim B, Dakour Aridi H, Malas M. Mortality after endovascular versus open repair of abdominal aortic aneurysm in the elderly. J Surg Res. 2017;215:153–9. https://doi.org/10.1016/j.jss.2017.03.061.

    Article  PubMed  Google Scholar 

  112. Halandras PM. Vascular surgery and geriatric patients. Clin Geriatr Med. 2019;35(1):93–101. https://doi.org/10.1016/j.cger.2018.08.008Review of the main vascular procedures and the changes to be considered in elderly patients.

    Article  PubMed  Google Scholar 

  113. Linn BS, Linn MW, Wallen N. Evaluation of results of surgical procedures in the elderly. Ann Surg. 1982;195(1):90–6. https://doi.org/10.1097/00000658-198201001-00013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Loyola University Medical Center, Maywood, IL, USA

    CM Tonelli, BJ Ringhouse, C Bunn & FA Luchette

  2. Edward Hines, Jr. Veterans Affairs Hospital, Deaprtment of Surgery, Hines, IL, USA

    CM Tonelli & FA Luchette

  3. Burn and Shock Trauma Research Institute, Loyola University Medical Center, Maywood, IL, USA

    C Bunn

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Tonelli, C., Ringhouse, B., Bunn, C. et al. The Impact of the Aging Population on Surgical Diseases. Curr Geri Rep 10, 21–31 (2021). https://doi.org/10.1007/s13670-020-00352-4

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