3%) and pneumonia (4.3%); these findings were similar to those of previous reports [13] in which post-operative pneumonia, cardiac complications and sepsis accounted for a large proportion of deaths in elderly patients. Cancer was reported to be the most common reason for death in elderly patients with abdominal emergency surgery in another study [4]. The different conclusions in that study might be explained by different patient populations, especially the number and percentage of patients with oncological emergency. Many factors have been reported to be responsible for surgical mortality during acute abdomen in elderly patients.
The most common factor was ASA score, which consists of 6 categories to evaluate the degree of a patient’s sickness or GDC-0973 cell line physical status, and that was reported as an independent prognostic factor in 3 previous studies [6, 13, 14]. ASA score is ordinarily used to assess the patient’s physical status before surgery by an anesthesiologist,
learn more whereas it is not commonly used by surgeons. The POSSUM scoring system developed by Copeland [10] in 1991 has since been applied to a number of surgical groups as surgical culture moves more towards outcome measures and providing the patient with as much information as possible to make fully informed decisions. The POSSUM scoring system has 2 main components: Physiological Score (PS) and Operative Severity Score Resveratrol (OSS). PS is based on 12 physiological
parameters to evaluate a patient’s physiological Syk inhibitor status before surgery, whereas OSS consists of 6 operative parameters accounting for the severity of the procedure. Since the ASA score is too simplistic and highly subjective compared to the APACHE II or POSSUM scoring system, we chose APACHE II and POSSUM (PS, OSS) as disease scoring systems instead of the ASA score in the study of prognostic factors for elderly patients who undergo emergency abdominal surgery. Consequently, the POSSUM score (PS) was identified as an effective prognostic factor in elderly patients who underwent emergency abdominal surgery on multivariate analysis. Since the PS in the POSSUM scoring system is objective and reflects the patient’s overall condition, including his age, vital signs, blood chemistry, mental status and heart condition, it may be more effective than the ASA score for evaluating the prognosis of elderly patients with abdominal surgical emergencies. Another effective prognostic factor defined in the present study was delay in hospital admission (more than 24 hours after onset of symptoms). The prognosis of the patient who was admitted more than 24 hours after onset of symptoms was significantly worsened than that of the patient who admitted within 24 hours on multivariate analysis (p = 0.0076).