Optimización de los procesos de gestión en cirugía electiva

Abstract

Aim: To determine one-year postoperative mortality in patients older than 65 years at the Hospital Clínico de la Universidad de Chile. Material and Methods: After approval by the ethics committee, a random sample of 235 patients was obtained from 2,832 patients ≥ 65 years who underwent surgery that required general or regional anesthesia. This sample size was calculated to detect a mortality incidence of 10% ± 5%, with a power of 80%, an α error of 0.05, and a loss of 10%. We recorded the demographic variables together with the Charlson Comorbidity Index (CCI) score from the electronic medical records. While the date of mortality was obtained from the Civil Registry. Results: We studied 233 patients with an age of 73.1 ± 6.3 years, 52.4% were women, and a mean CCI score of 4 (2-11) points. In total 65.7% underwent general anesthesia, 34.3% underwent regional anesthesia, and 24% underwent major surgery. Mortality at 30 days was 1.3% and at one year it was 6%. The patients who died were older and had a higher CCI, especially due to a higher incidence of dementia and solid tumors with metastases. Conclusions: In our study, postoperative mortality at one year was lower than those reported in older adult patients, and deceased patients were older with more comorbidities, especially with solid tumors with metastases and dementia.