Health

Monday 22 September 2014

Fitness not age is what matters on the operating table

Research has found fit pensioners over the age of 75 have mortality rates less than half those of unfit younger patients, following surgery.

A patient’s fitness - not their age - should be the key factor in deciding whether they have an operation, a major study has concluded.

A patient’s fitness - not their age - should be the key factor in deciding whether they have an operation, a major study has concluded.

The research found that fit pensioners over the age of 75 have mortality rates less than half those of unfit younger patients, following surgery.

Doctors have traditionally seen age as one of the main risk factor in operations, with older patients assumed to have a slower recovery time, a lower chance of survival and a higher risk of complications.

However, the three-year-study of almost 400 patients found that being physically fit before a procedure was far more important than the patient’s biological age.

Fit older people had a lower risk of dying, recovered better after surgery and had a shorter stay in hospital than unfit younger people, researchers found.

The study, published in the Annals of Surgery, involved 389 patients who underwent elective liver surgery at Newcastle’s Freeman Hospital.

Their fitness levels were assessed on bike tests before their operation and then their outcomes were monitored.

The best results were for fit patients below the age of 75, who had a mortality rate of 1 per cent. For those over 75 and fit the rate was 4 per cent - far lower than the 11 per cent death rate among younger patients who had been assessed as “unfit”.

The worst off group were unfit patients above the age of 75, who had a mortality rate of 21 per cent.

The study by Newcastle University and Newcastle Hospitals NHS Foundation Trust found that regardless of age, people who were physically unfit spent on average 11 days longer in hospital than those who were in better shape.

Older people who were fit spent the same time in hospital as fit younger people.

Professor Mike Trenell, the study’s lead researcher, an National Institute for Health Research senior fellow at the University, said: “To ensure the best possible outcome after surgery, we have found that it doesn’t matter how old you are - it matters how fit you are.”

The study by also found that that the longer recovery times of unfit patient meant they each cost the NHS an extra £6,000 each.

Prof Trenell said: “This data reinforces how important it is to be physically fit before surgery, no matter how old you are. We’re not talking about being an athlete but fit enough to ride a bike.”

He said the findings demonstrate that older patients should not be ruled out for surgery. However, he said doctors needed to take more care in assessing the wellbeing of older patients, before taking a decision.

“Being older does not necessarily mean that you shouldn’t have surgery,” said Prof Trenell. “But, if a patient is older and has a low level of physical fitness, the care team can now have an informed conversation with them about whether surgery is the best option for them.”

Laura Donnelly

Telegraph.co.uk

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