Factors related to mortality in geriatric patients after elective surgery: a retrospective cohort study

Introduction: The increased number of surgery on the elderly is often followed by an increased risk of mortality rate. Identifying the risk factors of surgical death in elderly patients will be mandatory before making a decision. This study aimed to determine mortality-associated factors in older people who underwent inpatient elective surgery. Methods: This cohort retrospective study analyzed secondary data from the medical records of geriatric patients hospitalized at Dr. Kariadi Hospital Semarang in 2020. Patients aged ≥ 60 years and who have undergone elective surgery were included. Patients with incomplete medical records, who had undergone outpatient surgery, more than one surgery, and emergency surgery, Covid-19, were excluded. A total of 382 patients met the criteria. In this study, independent variables analyzed were age, sex, nutritional status based on body mass index, functional status by Barthel, marital status, residence status, number of comorbidities according to Charlson Comorbidity Index, albumin levels, electrocardiogram (ECG) abnormalities, surgery type, and American Society of Anesthesiologists (ASA) status. The dependent variable was in-hospital mortality. In the logistic regression analysis, we identified the five most significant variables to allow for the prediction of in-hospital mortality. Results: Residence status (p= 0.003), ECG (p= 0.001), comorbidity (p <0.0001), albumin status (p< 0.0001), and ASA status (p< 0.0001) were identified as factors that affect postoperative mortality after multivariate analysis. Conclusion: In this study, mortality-associated factors were living alone, ECG abnormality, comorbidity > 2, hypoalbumin, and ASA > 2.