This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Giannice, R. Articles by Scambia, G. Search for Related Content PubMed PubMed Citation Articles by Giannice, R. Articles by Scambia, G. Related Collections Surgery

Perioperative Morbidity and Mortality in Elderly Gynecological Oncological Patients (70 Years) by the American Society of Anesthesiologists Physical Status Classes

From the Department of Obstetrics and Gynaecology (RG, EF, AP, SM, GS), Catholic University of Sacred Heart of Rome, Rome, Italy; Department of Obstetrics and Gynaecology (RG), Civil Hospital of Legnano, Milan, Italy; and Department of Anaesthesiology (EM), Catholic University of Sacred Heart of Rome, Rome, Italy.

Correspondence: Address correspondence and reprint requests to: Giovanni Scambia, MD, PhD, Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy; Fax: 39-06-355-08736; E-mail: giovanniscambia{at}libero.it

Background: We evaluated the morbidity and mortality associated with American Society of Anesthesiologists (ASA) classes III and IV versus ASA classes I and II in elderly women (70 years) undergoing gynecological oncological surgery.

Methods: From 1986 to 2000, we retrospectively collected patients 70 years of age undergoing oncological gynecological surgery. The study population consisted of 121 ASA class III and IV patients. The control group consisted of the same number of patients with ASA classes I and II, and these were matched to study patients (1:1) by clinical and surgical data. The morbidity and mortality of patients with ASA status III and IV were analyzed before and after 1992.

Results: In ASA class III and IV patients, compared with ASA class I and II, a higher rate of severe morbidity (P = .000) occurred, whereas the median postoperative stay was similar (8 days). No differences between patients with ASA class III and IV and ASA class I and II for median operative time, transfusion rate, or median blood loss were found. Mortality was 3% in ASA classes III and IV.

Conclusions: Our study suggests that surgery in elderly gynecological oncological patients aged 70 years with ASA class III or IV results in an acceptable perioperative morbidity and mortality rate.

Key Words: Elderly patients • Morbidity • Mortality • Gynecological cancer • Oncological surgery • ASA classes