Because age alone is a poor predictor of postoperative outcomes, the focus of the risk assessment should instead be on patient frailty and comorbidities, both of which are more predictive of outcomes than age. If the patient does opt for surgery, the surgeon should consider that free-flap reconstruction in the elderly can be performed with a high degree of success and that the flap outcome does not appear to be solely affected by age.
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November 2017Dr. Pullen is a freelance medical writer based in Illinois.
Take-Home Points
- The United States now has 45 million Americans who are 65 years or older.
- Surgical outcomes for the elderly include physical and mental functions.
- Tools such as the ACS NSQIP risk calculator can help surgeons predict which patients will experience complications or mortality from the procedure.
- New data suggest that two-thirds of patients 80 years or older have no serious complications from otolaryngology surgery.
Questions to Ask When Deciding Whether to Operate
- Can I get this patient through surgery and postoperative recovery?
- Can this patient tolerate adjuvant therapy?
- What are the patient’s comorbidities?
- What is the patient’s cancer-free survival prognosis?
- What is the natural expected life expectancy for this patient regardless of their cancer?
- Is there benefit to locoregional disease control with surgery?
- Are newer, novel, and effective nonsurgical options available?
- What outcomes really matter to the patient?