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CIR - Comunicações e Conferências

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http://hdl.handle.net/10400.10/213

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Browsing CIR - Comunicações e Conferências by Subject "Aged"

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  • Colorectal surgical mortality and morbidity in elderly patients: comparison of POSSUM, P-POSSUM, CR-POSSUM and CR-BHOM
    Publication . Gomes, A; Rocha, R; Marinho, R; Sousa, M; Carneiro, C; Pignatelli, N; Nunes, V
    2013Conference object Open access Show more
  • Emergency Hartmann´s procedure: short term outcomes in the old and the very old
    Publication . Rocha, R; Gomes, A; Marinho, R; Sousa, M; Carneiro, C; Nunes, V
    Objectives: Emergency Hartmann´s procedure is associated with significant morbidity and mortality, particularly in the elderly populations. Our aim is to compare the short term outcomes of old [65-80 years old[ and very old patients (80 or more) submitted to this procedure. Materials: Between January 2008 and December 2012 we submitted to emergency Hartmann´s procedure 105 patients: 65 old and 40 very old. We retrospectively reviewed patient charts and comparatively analysed demographic data, indications to surgery, P-POSSUM, ASA, intensive care unit stay, medical and surgical morbidity and 30-day mortality and performed univariate and multivariate logistic regression analysis. Results: x female, years . Comparing the Old and Very Old groups - Neoplasia (41% vs 47,5%), Acute Diverticulitis (31% vs 22,5%); 30-day mortality rate of 10% vs 45% (p value<0,05). Conclusions: Very old age was an independent factor of morbidity and mortality in emergency Hartmann´s procedure in our patients.
    2013Conference object Open access Show more
  • P-POSSUM as a predictor of colorectal surgical mortality in elderly patients
    Publication . Gomes, A; Rocha, R; Marinho, R; Sousa, M; Carneiro, C; Pignatelli, N; Nunes, V
    The PPOSSUM score is considered an adequate predictor of surgical mortality in colorectal surgery. The proportion of elderly surgical patients is rising. They must be considered as a different population. Our aim was to evaluate the predictive value of P-POSSUM for colorectal surgical mortality in patients age 80 or more. Retrospective observational study. Patients with 80 years old or more who underwent colorectal surgery at our institution between 2008 and 2012 were included. Subgroup analysis was performed for malignant, urgent and elective surgery. Parametric tests were used. 202 patients were enrolled, 55% men, mean age 84,27±3,94 [80-99].Surgical mortality was 16,8%. The physiology score (PS) was 23,22±5,09; operative severity score (OS) was 13,54±4,11; predicted mortality (PM) was 8,00%±10,87. Age, PS and PM were higher among patients with surgical mortality (t=0,996 df=200 p<0,01; t=0,999 df=200 p<0,01; t=0,987 df=200 p<0,01). No differences were observed in OS. These results were also observed when subgroup analyses was done. Predicted/observed mortality ratio was 0,46 (0,58 for patients who underwent urgent surgery). P-POSSUM underestimates surgical mortality of colorectal surgery in patients 80 years or older. Higher PS was associated with surgical mortality but OS was not. This was independent of subgroup analysis.
    2013Conference object Open access Show more