A retrospective review of our anesthetic approaches in patients age of 85 and over

Elderly; is defined as physiological and functional irreversible loss of function. Due to the changes that occur with aging, the elderly need more medical support. As the age increases, the increase in this requirement will increase the morbidity and mortality in anesthesia applications, especially in individuals aged 85 and over. In our study, we aimed to examine and develop our anesthetic approaches and to compare them with the current literature. After obtaining the ethics committee approval, 242 patients aged 85 years and older who underwent surgery between 01.01.2020 and 01.01.2022 were included in this study. The gender, age, comorbidities, transthoracic echocardiograms, types of anesthesia applied during the operation, operation times, postoperative service/intensive care follow-up periods, intraoperative blood products use and postoperative mortality of the patients were examined. Of the patients included in this study, 130 were female and 112 were male. The mean age was 87.95±2.57 years. While 6.2% of the patients did not have any co-morbidity, 93.8% had co-morbidities. The most common co-morbidities were Hypertension (70.7%), Diabetes Mellitus (18.6%), Coronary Artery Disease (34.7%), and Chronic Obstructive Pulmonary Disease (15.3%), respectively. The most common valvular heart disease in patients who underwent echocardiography was the coexistence of Aortic, Mitral and Tricuspid Regurgitation (38.3%), while the least observed was Mitral Regurgitation with a frequency of 2.6%. When we look at the anesthesia method applied; patients was operated with general anesthesia 65.3%, spinal anesthesia 29.8%, and sedation 5%. While 30.6% of the patients were admitted to the intensive care unit after the surgery, 69.4% of them were admitted to the ward. While the average of the operation time was 122 ± 58.69 minutes, the median hospitalization time was 7 days. During the surgery, 12.4% of the patients used blood products. While 88% of the patients were discharged with recovery, 5.4% died in the first 7 days and 6.6% in the first 1 month. When we classify the patients aged 85 and over as who underwent general anesthesia and regional anesthesia according to the anesthesia method; duration of hospital stay, amount of intraoperative bleeding, and positive results in favor of regional anesthesia in patients with Alzheimer's dementia were found to be statistically significant. We believe that there is a need for more research and national guidelines on the anesthetic approach for patients aged 85 and over. Keywords:85 years and older, geriatric anesthesia, mortality