Risk factors for overall postoperative complications in elderly patients undergoing gastrointestinal surgeries: a multicenter observational study.
10.12122/j.issn.1673-4254.2025.04.08
- Author:
Xuecai LÜ
1
;
Yanhong LIU
1
;
Shiyi HAN
1
;
Haoyun ZHANG
1
;
Aisheng HOU
1
;
Zhikang ZHOU
1
;
Likai SHI
1
;
Jie GAO
1
;
Jiangbei CAO
1
;
Hong ZHANG
1
;
Weidong MI
1
Author Information
1. Department of Anesthesiology, First Medical Center, Beijing 100853, China.
- Publication Type:English Abstract
- Keywords:
elderly patients;
gastrointestinal surgery;
pain;
postoperative complications;
risk factors
- MeSH:
Humans;
Postoperative Complications/etiology*;
Aged;
Risk Factors;
Digestive System Surgical Procedures/adverse effects*;
Male;
Female;
China/epidemiology*;
Pain, Postoperative/epidemiology*;
Incidence;
Aged, 80 and over
- From:
Journal of Southern Medical University
2025;45(4):736-743
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the risk factors of overall postoperative complications in elderly patients undergoing gastrointestinal surgeries.
METHODS:This study was conducted among a total of 1388 elderly patients, who underwent elective gastrointestinal surgeries at 17 centers across China between April, 2020 and April, 2022. The primary outcome was the incidence of postoperative complications within 30 days, including procedure-related, neuropsychiatric, respiratory, cardiovascular, and gastrointestinal complications as well as acute kidney injury. Baseline characteristics, preoperative psychological and functional status, intraoperative anesthesia and surgical factors, intraoperative medication, use of nerve block, and postoperative analgesia methods were compared between the patients experiencing one or more postoperative complications and those without complications. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for postoperative complications. The relationship between postoperative acute pain and each type of complication were explored.
RESULTS:The incidence of overall postoperative complications was 50.8% (705/1388) in these patients. Multivariate analysis showed that age (OR: 1.026; 95% CI: 1.006-1.046), prognostic nutritional index (OR: 0.998; 95% CI: 0.997-1.000), preoperative EuroQol-5 dimensions score (OR: 0.094; 95% CI: 0.018-0.500), blood loss (OR: 1.002; 95% CI: 1.001-1.003), and acute postoperative pain (OR: 1.308; 95% CI: 1.033-1.657) were significantly associated with the occurrence of postoperative complications. Specifically, patients experiencing severe postoperative pain had a significantly higher incidence of neuropsychiatric (27.2% vs 19.8%), procedure-related (17.3% vs 10.2%), and cardiovascular complications (3.6% vs 1.7%).
CONCLUSIONS:An advanced age, a low preoperative nutritional index, a poor quality of life score, a greater volume of intraoperative blood loss, and acute postoperative pain are independent risk factors for postoperative complications in elderly patients undergoing gastrointestinal surgeries. There is a significant association between acute postoperative pain and multi-system complications.
