Surprisingly Large Amount Of Surgeries Carried Out On The Elderly

Editor's Choice
Main Category: Seniors / Aging
Also Included In: Public Health
Article Date: 05 Oct 2011 - 20:00 PDT


Research published today (Wednesday 5th Oct) in the Lancet shows a surprisingly high rate of elderly people undergoing surgery in their final year, month or even week of life.

In one of the most detailed studies of people undergoing treatment on Medicare researchers looked at figures nationally and discovered that close to one in three people had surgery in their final year of life, with one in five in the last month and as many as one in ten in the last week.

Those aged 65 had the most amount of procedures in their final year, coming in at 38.4 percent or nearly one in four. At 80 the rate fell to 35.3% and there after dropped dramatically with only 33 percent of those at 90 under going a procedure.

Critics of the research say that the data is likely to be somewhat biased because researchers looked only at those who died. It also doesn't take into account the type or reason for the surgery. Peter B. Bach from Memorial Sloan-Kettering Cancer Center weighs in on the issue :

"Because the patient died, you can't assume that the treatment and therapies were not of value ..... Although in that individual, things may not have worked out, you have no insight into whether the decision to operate was appropriate."

Another factor that has not been taken into account is how many similar patients who had that same surgery did not die. It would appear that the issue is somewhat more complex than it appears and further investigation of the topic is required.

Nonetheless the large percentages of people having surgery in their final year of life was a surprise to researchers, obviously some surgeries were necessary to prolong life or ease pain, however a point was clarified by the team at Harvard School of Public Health who undertook the research, that doctors might operate to more out of sympathy to make repairs where they are able, yet knowing full well that it might not save a dying patient.

The Harvard team in all took data from nearly two million Medicare patients aged 65 and over who died in 2008. They also report finding large variations from state to state and city to city, with Honolulu coming in with figures one third of that in Gary, Indiana.

Dr. Ashish Jha, an associate professor of health policy at Harvard and the lead author of the study, pointed out the gap in the figures:

"Honolulu and Gary, Ind., can't both be doing it right,"

Despite the critics, researchers believe they have unearthed a real flaw in the American Medical system: Surgical Intervention which can be painful and debilitating remains tempting for both doctors and patients alike.

Dr. Jha concludes:

"I will admit to being guilty of this .... Often we say: If you have this intervention, we will be able to fix that problem. You have an intestinal blockage. Surgery will fix it.' But will it let you walk out of the hospital alive? Will it let you return to your old life?"

Rupert Shepherd reporting for Medical News Today.com

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