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Surgery risks high for seniors: study

One in 20 elderly Australians who undergo surgery die within a month of going under the knife, new research finds.

A major review of operations performed in Australian and New Zealand hospitals has found 5 per cent of patients aged over 70 died soon after their procedure.

Some 20 per cent experienced serious or life-threatening complications after their surgery.

Associate Professor David Story of Melbourne’s Austin Hospital, who led the research, said that while the figures appeared to be high, it was the result of surgery becoming "a lot safer" for older Australians.

Advances in technology and technique handed the option of surgery to increasingly "older and sicker patients", he said, and this presented an array of new and sometimes deadly risks.

"The major point is, surgery has become a lot safer, we're saying surgeons have made surgery a lot safer and we're now operating on older and sicker patients," said Story.

"That has tipped the balance, and the big risk now for a lot of patients is themselves."

The study took in more than 4100 operations performed across 23 metropolitan and regional hospitals.

Joint replacements, hernia and gall bladder removal, cancer-related bowel surgery, and ear nose and throat surgeries were common operations included in the study.

It deliberately excluded cardiac surgeries, whose patients all recover in intensive care.
The research showed at least half of the elderly surgical patients also had complex health problems in need of close management.

These health problems were "often far more important than the operation itself", Story said, and this scenario required a "very different way of thinking" about surgery.

More of a focus was needed on managing an aged patient's individual health problems before, during and after their operation, he said.

Surgical techniques, and post-operative care plans, that were best practice in healthy patients could not simply be applied "cookie-cutter style" to aged patients.

"The cookie-cutter style has some advantages in getting people to focus on the issues, but we need to individualise the care," Story said.

"We now know that with patients with complex medical problems, it's very important to individualise treatment under a highly specialised care regime before, during and after surgery."

Story said the nation's population was ageing, meaning more older people would turn up in hospitals, and they needed a "systematic approach to deal with it".

The study findings were published in the journal Anaesthesia.

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