New methods provide increased survival for the elderly after surgery

A recent study by researchers at Karolinska Institutet and Karolinska University Hospital shows that survival rates after surgery have significantly improved over the years, even though patients have become sicker and older. One contributing factor is the continuous development of perioperative care, which encompasses patient management before, during, and after surgery.

Aging population affects all sectors of health care. The purpose of the study, published in the International Journal of Surgery, was to investigate whether surgical patients were getting older and sicker, and if this led to a lower survival rate among patients. Instead, the study showed that survival rates increased over time.

In the study, researchers examined over 600,000 surgeries performed between 2006 and 2021 at Karolinska University Hospital. The patients ranged from 18 to over 75 years old.

More elderly patients underwent surgery

Although the proportion of younger patients undergoing surgery decreased during the period, the oldest age category increased. Advances in patient care for this group may explain the reduced mortality.

"Interestingly, we observed a significant improvement in survival rates after surgery over the years, despite patients becoming sicker and older, with the greatest improvement among the oldest and sickest individuals," says Ellen Leigard, a doctoral student at the Department of Physiology and Pharmacology at Karolinska Institutet and a specialist physician in anesthesia and intensive care at Karolinska University Hospital.

"During the study period, there has been substantial development in areas such as medication, minimally invasive surgical techniques, and treatments, which may contribute to explaining these results. This places entirely different demands on the care of these patients today and in the future," Leigard adds.

It's a positive trend that shows older patients have a better chance of surviving surgeries. Perioperative care, which includes care before, during, and after surgery, continues to evolve.

Health care in constant development

Both anesthesia and surgery, however, face challenges in caring for older and multimorbid patients.

"Both specialties face significant challenges precisely because we are becoming increasingly adept at caring for elderly and multimorbid patients. We will need to be creative and smart in how we approach the challenge posed by an aging population. Both new approaches and new technology may have a place in health care going forward," concludes Max Bell, research group leader at the same institution at Karolinska Institutet and chief physician in perioperative medicine and intensive care at Karolinska University Hospital.