# The Significance of Emergency Surgical Operations for Severe Elderly Patients Considering Medical Costs and Activities of Daily Life

## TL;DR

This study examines the outcomes of emergency surgery in elderly patients, finding that while medical costs are similar across age groups, older patients face challenges in recovery and daily living.

## Contribution

The study provides insights into the clinical and functional outcomes of emergency surgery in elderly patients, particularly those aged 85 and older.

## Key findings

- Patients aged ≥85 years had significantly lower preoperative and postoperative ADL scores.
- Hospital mortality was highest in Group E but not statistically significant.
- Fewer patients aged ≥85 were discharged directly home compared to younger groups.

## Abstract

Purpose

The global population is aging rapidly, and physicians increasingly face challenges in determining the appropriateness of emergency surgery for elderly patients. This study aimed to evaluate the clinical significance of emergency operations in elderly patients.

Methods

This retrospective clinical study included patients transferred to the emergency department of Gunma University Hospital and admitted to the intensive care unit following emergency surgery between January 2013 and December 2019. Patients were categorized into three age groups: 18-64 years (Group Y), 65-84 years (Group M), and ≥85 years (Group E). Clinical courses, including activities of daily living (ADL), were compared across groups. The primary outcomes were hospital mortality and the proportion of patients discharged directly home; secondary outcomes included additional clinical characteristics.

Results

A total of 84 patients were included: 30 in Group Y, 42 in Group M, and 12 in Group E. Both preoperative and postoperative ADL scores were significantly lower in Group E. Medical costs did not differ significantly among the groups. Although hospital mortality was highest in Group E, the difference was not statistically significant. However, the proportion of patients discharged directly home was significantly lower in Group E.

Conclusions

Emergency operations in patients aged ≥85 years may achieve outcomes comparable to those in younger patients; however, the total treatment period is likely to be prolonged due to significantly reduced postoperative ADL.