Surgical intervention in elderly people improves quality of life

Age alone should not determine surgical risk in a person age 80 or over, according to expert commentary from Mark Katlic, M.D., director of Thoracic Surgery at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, Pa.

Dr. Katlic's commentary complements a McGill University Health Science Center trend study, appearing in this week's edition of the Canadian Medical Association Journal (CMAJ). The study finds an increase in coronary artery bypass grafts (CABGs) and percutaneous coronary interventions (PCIs) with better results in people previously believed to be too old for these procedures.

Physiologic age can be very different from chronologic age, according to Dr. Katlic, a thoracic surgeon and geriatric surgery specialist.

"I've seen 95-year-old patients who are in far better health than patients 20 years younger," noted Dr. Katlic. "In these patients, a surgical intervention (that is indicated) will almost always improve - and not diminish - quality of life."

As baby boomers bend life expectancy curves, an increasing number of them will be considering aggressive surgical procedures in their advanced years.

"We need a simple and reliable test, the elusive object searched for by those of us in the field, sort of the Holy Grail of geriatric surgery," said Dr. Katlic, "to help elderly patients and their doctors better estimate the risk of undergoing a surgical procedure."

Editor of several definitive geriatric surgery textbooks and a frequent national speaker on geriatric surgery topics, Dr. Katlic suggests that appropriate surgical intervention in the elderly usually decreases medical costs. He said that despite related co-morbidities, such as diabetes, the intervention generally reduces condition-specific hospital admissions and readmissions.

"This is a topic that demands more research," he noted.