Tags: risk | senior | surgery | procedure | operation

Top 10 Riskiest Surgeries for Seniors

By    |   Thursday, 19 February 2015 05:04 PM

Some common surgeries for seniors are so “high risk” they should be performed only after patients have had detailed conversations with their doctors about the potential harms, according to a new study listing 227 operations with high death rates.
 
Those riskiest procedures, detailed in the journal JAMA Surgery, include heart valve operations, coronary artery bypass grafting, small bowel resection, and surgical removal of the lungs.
 
The researchers said designation of a surgery as high risk “presents an opportunity for patients to pause and consider the value of surgery over alternative treatments… prepare for the real potential of an unwanted outcome.”
 
The researchers created the list using admissions data of patients 65 years and older between 2001 and 2007. They found a broad collection of high-risk cardiac, gastrointestinal, neurosurgical, thoracic, urological, and vascular procedures.

Ten surgeries were the most problematic for older patients during emergency admissions:
  • Adrenal gland removal.
  • Removal of plaque buildup from the carotid arteries.
  • Arm blood-vessel replacement.
  • Abdominal vein resection or replacement.
  • Varicose vein removal.
  • High gastric bypass.
  • Proctopexy.
  • Bile duct excision.
  • A urinary reconstruction technique.
  • Ureter repair.
For both urgent and elective admissions, 227 surgeries that were high risk for patients 65 and older, compared with 154 for younger patients.

The high-risk procedures are also among the 20 most costly surgeries in the U.S., according to a 2014 report from the Agency for Healthcare Research and Quality.

The mean costs per hospital stay for those surgeries were $53,400 for heart valve procedures, $38,700 for CABG, $34,500 for small bowel resection, and $23,000 for the surgical removal of one or both lungs, the AHRQ report found.

“The risks and benefits of surgery should be carefully evaluated to assure that trade-offs between surgical treatment and nonsurgical options have been fully considered,” said the researchers, including experts from the University of Wisconsin at Madison, the University of Pittsburgh, Beth Israel Deaconess Medical Center in Boston, and the University of Utah in Salt Lake City.

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Some common surgeries for seniors are so risky they should be performed only after patients have had detailed conversations with their doctors about the potential harms, according to a new study listing 227 operations with high death rates.
risk, senior, surgery, procedure, operation
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2015-04-19
Thursday, 19 February 2015 05:04 PM
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