Risk factors for overall postoperative complications in elderly patients undergoing gastrointestinal surgeries:a multicenter observational study
LÜ Xuecai
LIU Yanhong
HAN Shiyi
ZHANG Haoyun
HOU Aisheng
ZHOU Zhikang
SHI Likai
GAO Jie
CAO Jiangbei
ZHANG Hong
MI Weidong
Abstract：Objective 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.
Keywords：gastrointestinal surgeryelderly patientsrisk factorspostoperative complicationspain
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 736-743 )