John Libbey Eurotext

Gériatrie et Psychologie Neuropsychiatrie du Vieillissement

Interest of a medical surgical geriatric unit in a district hospital: a retrospective study Volume 15, issue 3, Septembre 2017

Authors
1 Service de soins de suite et de réadaptation, Centre hospitalier du Forez, Feurs, France
2 Service de santé publique et information médicale, CHU Hôpital Nord, Saint-Étienne, France
3 Service de chirurgie et unité médico-chirurgicale gériatrique, Hôpital du Gier, Saint-Chamond, France
4 Service de soins de suite et de réadaptation gériatrique, Hôpital du Gier, Saint-Chamond, France
5 Service de court séjour gériatrique et unité médico-chirurgicale gériatrique, Hôpital du Gier, Saint-Chamond, France
6 Département de gérontologie clinique, CHU Hôpital Charité, Saint-Étienne, France
* Tirés à part
  • Key words: surgery, elderly, mortality, comorbidity
  • DOI : 10.1684/pnv.2017.0681
  • Page(s) : 231-41
  • Published in: 2017

Background: Orthogeriatric units have shown through several studies their effectiveness on reducing the morbidity and mortality after hip fracture. What about other emergency surgeries at the elderly? We evaluated the results of a small medical surgical geriatric unit (UMCG) for all the not sheduled surgeries. Methods: A retrospective sudy has been done, analyzing management of patients over 75 years after an emergency surgery, between 1st January 2013 and 15 February 2014 for the surgical unit, and between 15 February 2014 and 15 April 2014 for the UMCG. 3-month mortality, 6-month mortality and the main early complications were compared between the two groups, by a multivariated analysis fitting on the data on patient characteristics. Results: 3-month mortality was significantly lower in the UMCG group (odds ratio 0.07 [95%IC: 0.004-0.48]; p=0.02), while the patients in this unit were more likely with dementia, with fall antecedent and with more comorbidity. 6-month mortality as well was lower in the UMCG group (0.10 [0.02-0.36]; p=0.001). Conclusion: Management of not sheduled surgeries at the elderly in specific surgical geriatric unit is associated in a statistically significant reduction of 3-month mortality and 6-month mortality.