2007, Number 3
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Rev Hosp Jua Mex 2007; 74 (3)
Surgical abdomen acute in the geriatric patients
Muñiz CM, Núñez TLA, López FC, BMM, García ÁJ, Pérez GR
Language: Spanish
References: 47
Page: 174-185
PDF size: 74.37 Kb.
ABSTRACT
Background. The surgical managing of the sharp (acute) abdomen is a pathology that presents high morbimortality. The present study analyzes the managing between the young patients and the geriatrics.
Results. There were selected 134 patients of which 110 were minor 64 years (A Group) and the 24 remaining ones were older than 65 years (B Group). In the A Group, 32 of the patients (29.1%) presented pathological disorders with only a pathology in 85% of the cases and in the B Group only 18 (75%), being in 70% of the cases of multiple pathology. The days of intrahospital stay for the A Group was of three days in average, and in the B Group was seven. The mortality in the A Group was three (0.9%) and in the Group B two (1.8%).
Conclusions. The managing of the sharp (acute) abdomen of the geriatric patient in the Hospital Juarez de Mexico has a major mortality, which is related to the number of previous pathologies, this causes that the geriatric patient presented a generally complicated postoperatory which increases (their) hospital stay.
REFERENCES
Costa PT, McCrae RR. Concepts of functional or biological age. A critical review. In: Andres R, Bierman EL, Hazzard WR (eds.). Principles of geriatric medicine. EUA: McGraw Hill; 1985, p. 30-7.
D’Hyver C. Geriatría. México: Editorial Manual Moderno; 2005, p. 15-31.
Kanungo MS. Biochemistry of anging. New York: Academic Press; 1980, p. 27-40.
Priebe HJ. The aged cardiovascular risk patient. Br J Anaesth 2000; 85(5): 163-778.
Fliser D. Renal function in the elderly impact of hypertension and cardiac function. Kidney Inter 1997; 51(4): 1196-200.
Gary SH. Morphometric study on arterioles and glomeruli in the aging kidney suggests focal loss of autoregulation. Kidney Int 2003; 63: 1027-36.
Hoang K, Tan IC, Derby G, et al. Determinants of glomerular hypofiltration in aging humans. Kidney Inter 2003; 64: 1417-24.
Maclachlan MSF. The aging kidney. Lancet 1978; 2: 143-6.
Wahba WB. Influence of age in lung function - clinical significance of changes from age twenty. Anesth Analg 1983; 62: 764-76.
Vernadakis A. The anging brain. Clin Geriatr Med 1985; 1: 61-94.
Lawry P. Comparative pharmacokinetic changes and drug therapy in an older population. J Am Geratr Soc 1982; 30 (Suppl.): S11-S19.
Thompson EN, Williams R. Effect of age on liver function with particular reference to bromosulphalein excretion. Gut 1965; 6: 266.
Woodhouse KW, Mutch E, et al. The effect of age on pathways of drug metabolism in human liver. Age Ageing 1984; 13: 328-34.
Fenske AN, Lober W, Clifford. Structural and functional changes of normal aging skin. J Am Acad Dermatol 1986; 15(4): 571-82.
Linn BS, Linn M, et al. Evaluation kof resuts of surgical procedures in the elderly. Ann Surg 1982; 19: 90-6.
De Dombal FT. Acute abdominal pain in the elderly. J Clin Gastroenterol 1994; 19: 331-5.
Bugliosi TF, Meloy TD, Vulov LF. Acute abdominal pain in the elderly Ann Emerg Med 1990; 19: 1383-6.
Sanson TG, O’Keefe KP. Evaluation of abdominal pain in the elderly. Emerg Med Clin North Am 1996; 14: 615-27.
Kauvar DR. The geriatric acute abdomen. Clin Geriatr Med 1993; 9: 547-58.
Dang C, Aguilera P, Dang A, Salem L. Acute abdominal pain. Four classifications can guide assessment and management. Geriatrics 2002; 57: 30-6, 41-2.
Mezey E. Diseases of gallbladder biliary tree. In: Hazard WR, Blass JP, Ettinger WH Jr., Halter JB, Ouslander JGH (eds.). Principles of geriatric medicine and gerontology. 4th Ed. New York: McGraw-Hill; 1999, p. 873-75.
Telfer S, Fenyo G, Holt PR, de Dombal FT. Acute abdominal pain in patients over 50 years of age. Scands J Gastroenterol Suppl 1988; 144: 47-50.
Hanau LH, Steigbigel NH. Acute (ascending) cholangitis. Infect Dis Clin North Am 2000; 14: 521-46.
Fenyo G. Acute abdominal disease in the elderly: Experience from two series in Stockholm. Am J Surg 1982; 143(6): 751-4.
Martin SP, Ulrich CD II. Pancreatic disease in the elderly. Clin Geriatr Med 1999; 15: 579-605.
Bentrem DJ, Joehl RJ. Pancreas: healing response in critical illness. Crit Care Med 2003; 31(Suppl): S582-9.
Paajanen H, Jaakkola M, Oksanen H, et al. Acute pancreatitis in patients over 80 years. Eur J Surg 1996; 162: 471-5.
Farrel RJ, Farrel JJ, Morrin MM. Diverticular disease in the elderly. Gastroenterol Clin North Am 2001; 30: 475-96.
McCarthy DM. Acid peptic disease in the elderly. Clin Geriatr Ned 1991; 7: 1027-37.
Voutilainen M, Mantynen T, Farkkila M, Juhola M, Sipponen P. Impact of non- steroidal anti-inflammatory drug and aspirin use on the prevalence of dyspepsia and uncomplicated peptic ulcer disease. Scand J Gastroenterol 2001; 36: 817-21.
Soybel Dl. Ileus and bowel obstruction. Surgery, scientific principles and practice. 2nd Ed. Lippincott-Raven; 1997, p. 817-31.
Maglinte DD, Reyes Bl, Harmon BH, Kelvin FM, Turner WW Jr, Hage JE, et al. Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol 1996; 167: 1451-5.
Soybel D. Ileus and bowel obstruction. In: Greenfield LJ, Mulholland MW (eds.). Surgery:Scientific principles and Practice. Philadelphia, PA: Lippincott-Raven; 1997, p. 817.
Avots-Avotins KV, Waugh DE. Colon volvulus and the geriatric patient. Surg Clin North Am 1982; 62: 249-60.
Bickerstaff LK, Hollier LH, Van Peenen HJ, Melton LJ III, Pairolero PC, Cherry KJ. Abdominal aortic aneurysms: The changing natural history. J Vasc Surg 1984; 1(1): 6-12.
U.S Preventive Services Task Force. Screening for abdominal aortic aneurysm: recommendation statement. Rockville, Md: Agency for healthcare Research and Quality, 2005. Accesado en marzo 15, 2006, en: http://www.ahrq.gov/clinic/uspstf05/aaascr/aaars.pdf.
Fielding JW, Black J, Ashton F, Slaney G, Campbell DJ. Diagnosis and management of 528 abdominal aortic aneurysm. Br Med J (Clin Res Ed) 1981; 283: 355-9.
Ruotolo RA, Evans SR. Mesenteric ischemic in the elderly. Clin Geriatr Med 1999; 15: 527-57.
Greenwald DA, Brandt LJ, Reinus JF. Ischemic bowel disease in the elderly. Gastroenterol Clin North am 2001; 30: 445-73.
Harari D. Constipation in the elderly. In: Hazard WR, Blass JP, Ettinger WH Jr., Halter JB, Ouslander JGH (eds.). Principles of geriatric medicine and gerontology. 4th Ed. New York: McGraw-Hill; 1997, p. 3-46.
Espinoza RG. Abdomen agudo en el adulto mayor. Rev Med de Chile 2004; 132: 1505-12.
Marco CA, Schoenfeld CN. Abdominal pain in geriatric emergency patients: Variables associated with adverse outcomes. Acad Emerg Med 1998, 5(12): 1163-8.
Fenyo G. Diagnostic problems of acute of acute abdominal diseases in the aged. Acta Chir Scand 1975; 143: 751-4.
Kettunen J, Paajanen H. Emergency abdominal surgery in the elderly. Hepatogastrenterology 1995; 42: 106-8.
Le Neel JC, Guibertau B. Management of patients over 75 years of age with digestive or abdominal disease. A series of 660 cases. Chirurgie 1993-94; 119: 143-7.
Cutler RG. Recent progress in testing the logetivity determinant and dysdifferentation hyphotheses of aging. Arch Gerontol Geriatr 1991; 12: 75-98.
Keller SM, Markovitz LJ, Wilder JR. Emergency and elective surgery in patients over 70. Am Surg 1987; 53: 636-40.