Marina Boruk, M.D., from the State University of New York Downstate Medical Center, Brooklyn, and colleagues, conducted a retrospective study of medical records, between January 1999 and January 2004, to determine if age alone is a predictor of outcomes for major head and neck surgery. The review included 157 cases of patients who had undergone a major head and neck surgical procedure, of whom 31 ( 20 percent ) were 70 years or older. The age of patients ranged from nine to 95 years, with an average of 56.1 years. Fifty-nine percent ( 92 ) were men and 41 percent ( 65 ) were women.
Patient's age alone was not found to be a predictive indicator of outcomes for major head and neck surgery. Time under general anesthesia ( TUGA ) was the only factor found to be consistently related to surgical complications and length of hospital stay. TUGA ranged from 75 to 1,160 minutes, with a median ( middle value ) of 240 minutes. The odds of a patient having a complication increased by 0.6 percent with every minute of anesthesia, therefore the odds of having a major complication increased by 36 percent every hour under anesthesia. The odds of having any complication ( major or minor ) increased by 18 to 36 percent for every hour under anesthesia, depending on the analysis. Being 70 years or older was not associated with complications or length of stay ( LOS ) in any of the researchers' analyses. The median length of stay for patients was three days in males and two days in females.
“Our findings support the growing acceptance that age, in and of itself, is not a risk factor for major head and neck surgery. … Care should be taken to carefully control preoperative comorbid conditions and offer the appropriate medical care,” the authors write. “TUGA showed a statistically significant relationship with complication rate and hospital LOS in multivariate analyses. This relationship held true for all age groups.”