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01-06-2014 | Original Article

Liver Resection in the Elderly: Significance of Comorbidities and Blood Loss

Authors: Tobias S. Schiergens, Carsta Stielow, Stefanie Schreiber, Cyrill Hornuss, Karl-Walter Jauch, Markus Rentsch, Wolfgang E. Thasler

Published in: Journal of Gastrointestinal Surgery | Issue 6/2014

Abstract

Objective

Liver resection is increasingly performed in elderly patients who are suspected of increased postoperative morbidity (PM) and reduced overall survival (OS). Patient selection based on the identification of age-adjusted risk factors may help to decrease PM and OS.

Design and Participants

Prospectively collected data of 879 patients undergoing elective hepatic resection were analyzed. This population was stratified into three age cohorts: >70 years (n = 228; 26 %), 60–69 years (n = 309; 35 %), and <60 years (n = 342; 39 %). Multivariate survival analysis was performed.

Results

The incidence of severe (p < 0.01) and non-surgical (p < 0.001) postoperative complications was higher in older compared to younger patients. Major estimated blood loss (EBL; p = 0.039) and comorbidities (p = 0.002) independently increased PM. EBL was comparable between all age cohorts. However, preexisting comorbidities, major EBL, and postoperative complications markedly decreased OS in contrast to younger patients. Adjusted for age, independent predictors of OS were comorbidities (HR = 1.51; p = 0.001), major hepatectomy (HR = 1.33; p = 0.025), increased EBL (HR = 1.32; p = 0.031), and postoperative complications (HR = 1.64; p < 0.001).

Conclusion

Although increased age should not be a contraindication for liver resection, this study accents the avoidance of major blood loss in elderly patients and a stringent patient selection based on preexisting comorbidities.

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Title: Liver Resection in the Elderly: Significance of Comorbidities and Blood Loss
Authors: Tobias S. Schiergens
Carsta Stielow
Stefanie Schreiber
Cyrill Hornuss
Karl-Walter Jauch
Markus Rentsch
Wolfgang E. Thasler
Publication date: 01-06-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 6/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2516-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Liver Resection in the Elderly: Significance of Comorbidities and Blood Loss

Abstract

Objective

Design and Participants

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and Participants

Results

Conclusion

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