75 Years Young: Fit Older Patients Prime Surgery Candidates

Traditionally, age is one of the main risk factors in determining whether or not you should have an operation. Doctors and wellness experts assume that, if you’re a little older, you will have a slower recovery time, a lower chance of survival and a higher risk of complications. However, a new study argues that it’s not about your age; it’s about your fitness.

According to the Newcastle University and Newcastle Hospitals NHS Foundation Trust researchers, who published their work in the Annals of Surgery, fit pensioners over the age of 75 have mortality rates less than half those of unfit younger patients, following surgery. The researchers assessed the fitness levels and outcomes of 389 patients who underwent elective liver surgery at Newcastle’s Freeman Hospital.

The results of the study revealed that fit older people had a lower risk of dying, recovered better after surgery and had a shorter stay in hospital than unfit younger people. Fit patients below the age of 75 fared the best, only having a mortality rate of 1%, while those who were fit and 75+ had a 4% mortality rate. This was a significant difference compared to younger patients who had been assessed as “unfit”, as these had an 11% death rate, but the worst off group were, naturally, unfit patients above the age of 75. These patients had a mortality rate of 21%.

According to study lead researcher Professor Mike Trenell, a National Institute for Health Research senior fellow at the University, ‘To ensure the best possible outcome after surgery, we have found that it doesn’t matter how old you are – it matters how fit you are.’ Physically unfit people, on average, spent 11 days longer in hospital than those who were in better shape, regardless of age. Professor Trenell commented, ‘This data reinforces how important it is to be physically fit before surgery, no matter how old you are. We’re not talking about being an athlete but fit enough to ride a bike.’

He added that while older patients aren’t always ruled out for surgery, doctors need to take more care in assessing the wellbeing of older patients, before taking a decision. ‘Being older does not necessarily mean that you shouldn’t have surgery,’ he said. ‘But, if a patient is older and has a low level of physical fitness, the care team can now have an informed conversation with them about whether surgery is the best option for them.’

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