Emergency general surgery in the geriatric patient
Abstract
Background: Emergency general surgery in the elderly is a particular challenge to the surgeon in charge of their care. The aim was to review contemporary aspects of managing elderly patients needing emergency general surgery and possible alterations to their pathways of care. Methods: This was a narrative review based on a PubMed/MEDLINE literature search up until 15 September 2015 for publications relevant to emergency general surgery in the geriatric patient. Results: The number of patients presenting as an emergency with a general surgical condition increases with age. Up to one-quarter of all emergency admissions to hospital may be for general surgical conditions. Elderly patients are a particular challenge owing to added co-morbidity, use of drugs and risk of poor outcome. Frailty is an important potential risk factor, but difficult to monitor or manage in the emergency setting. Risk scores are not available universally. Outcomes are usually severalfold worse than after elective surgery, in terms of both higher morbidity and increased mortality. A care bundle including early diagnosis, resuscitation and organ system monitoring may benefit the elderly in particular. Communication with the patient and relatives throughout the care pathway is essential, as indications for surgery, level of care and likely outcomes may evolve. Ethical issues should also be addressed at every step on the pathway of care. Conclusion: Emergency general surgery in the geriatric patient needs a tailored approach to improve outcomes and avoid futile care. Although some high-quality studies exist in related fields, the overall evidence base informing perioperative acute care for the elderly remains limited.
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Elderly, frail, and very co-morbid patients may not be surgical candidates, nor candidates for active intervention.
“Elderly, frail, and very co-morbid patients may not be surgical candidates, nor candidates for active intervention.”
From Acute mesenteric ischaemia (2023) · cites this paper as [17]
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“*e elderly had a higher mortality rate than young patients after emergency surgery, even those who were in a generally good physical condition [36].”
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Self-citation
- Authors
- Desserud, K. F., Veen, T., & Søreide, K.
- Affiliations
- Stavanger University Hospital (NO)
- Corresponding author
- Søreide, K
- ORCID
- Venue
- Journal of British Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-01-01
- Volume
- 103
- Issue
- 2
- Pages
- e52-e61
- ISSN
- 0007-1323 (ISSN-L)
- 1365-2168
- OpenAlex
- W2183433163
- Cited by
- 176
- References
- 90
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 15 · 2023: 18 · 2022: 24 · 2021: 25 · 2020: 27 · 2019: 16 · 2018: 16 · 2017: 17 · 2016: 1
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- British journal of surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Keywords
- emergency general surgery, elderly patients, geriatric surgery, frailty, comorbidities, perioperative outcomes, mortality, care pathways, early diagnosis, resuscitation, communication with relatives, ethical considerations, futility of care, risk score
- MeSH terms
- Aged, Emergency Treatment, Ethics, Medical, Forecasting, Health Services Accessibility, Hospitalization, Humans, Long-Term Care, Palliative Care, Patient Care Planning, Postoperative Care, Postoperative Complications, Preoperative Care, Risk Factors, Surgical Procedures, Operative, Geriatric Assessment, Advance Directives, Frail Elderly, Medical Futility
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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