Some problems worthy of attention in surgical diagnosis and treatment of elderly patients with acute abdomen_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Dequan ,  HOU Limin

Department of Emergency Surgery of the First Affiliated Hospital of Harbin Medical University, Harbin 150001, P. R. China;

Corresponding author：

HOU Limin, Email: houlimin1969@163.com

Keywords：

elderly patient; surgery risk; acute abdomen

DOI：

10.7507/1007-9424.202111020

Video：

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China has entered an aging society. Elderly patients with acute abdomen have complex clinical manifestations and often have more complications. For elderly acute abdomen, the results of abdominal physical examination and laboratory testing often can not reflect the patient’s condition. The differential diagnosis of diseases should be emphasized in clinical diagnosis and treatment. The treatment of acute abdomen in the elderly not only needs standardized analgesic treatment, but also pays attention to the evaluation of the disease, and adopts multidisciplinary cooperation to formulate appropriate treatment plans.

Citation： XU Dequan, HOU Limin. Some problems worthy of attention in surgical diagnosis and treatment of elderly patients with acute abdomen. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(8): 1078-1082. doi: 10.7507/1007-9424.202111020 Copy

1.	Xu D, Hou L, Zhou H. Challenges faced by acute care surgeons in China. World J Emerg Surg, 2019, 14: 16. doi: 10.1186/s13017-019-0236-3.
2.	宁吉喆. 第七次全国人口普查主要数据情况. 中国统计, 2021, 5: 4-5.
3.	World Health Organization. Populations are getting older. 12 February 2020. https://www.who.int/multi-media/details/populations-are-getting-older.
4.	国家卫生健康委员会. 中国卫生健康统计年鉴（2020）. 中国协和医科大学出版社, 2020: 122-126.
5.	Xu D, Yin Y, Hou L, et al. A special acute care surgery model for dealing with dilemmas involved in emergency department in China. Sci Rep, 2021, 11(1): 1723. doi: 10.1038/s41598-021-81347-9.
6.	Mayumi T, Yoshida M, Tazuma S, et al. The Practice Guidelines for Primary Care of Acute Abdomen 2015. Jpn J Radiol, 2016, 34(1): 80-115.
7.	吴海华. 多层螺旋CT在诊断老年急腹症中的临床应用价值及检出率分析. 影像研究与医学应用, 2021, 5(3): 213-214.
8.	Falch C, Vicente D, Haberle H, et al. Treatment of acute abdominal pain in the emergency room: a systematic review of the literature. Eur J Pain, 2014, 18(7): 902-913.
9.	北京大学医学部急诊医学学系. 成人非创伤性急腹症早期镇痛专家共识. 中国急救医学, 2021, 41(1): 11-17.
10.	周凤刚. 急腹症的病情判断和动态观察. 中国普外基础与临床杂志, 2009, 16(8): 665-666.
11.	吴国豪. 重视老年普通外科病人围手术期处理. 中国实用外科杂志, 2009, 29(2): 109-111.
12.	Ochsher A. Is risk of operation too great in the elderly? Geriatrics, 1967, 22（11）: 121-130.
13.	Brooks B. Surgery in patients of advanced age. Ann Surg, 1937, 105(4): 481-495.
14.	Wheatley BJ, Gorsuch JM, Mansour MA, et al. Vascular procedures in nonagenarians and centenarians are safe. Am J Surg, 2011, 201(3): 301-304.
15.	陈丹丹, 王杭芳. 老年肠梗阻患者急诊手术的临床特点. 中国老年学杂志, 2013, 33(22): 5750-5751.
16.	Hentati H, Salloum C, Caillet P, et al. Risk factors for mortality and morbidity in elderly patients presenting with digestive surgical emergencies. World J Surg, 2018, 42(7): 1988-1996.
17.	Li HX, Xue FS, Liu YY. Letter to the editor: Risk factors for mortality and morbidity in elderly patients presenting with digestive surgical emergencies. World J Surg, 2018, 42(12): 4127-4128.
18.	Sangji NF, Bohnen JD, Ramly EP, et al. Derivation and validation of a novel Emergency Surgery Acuity Score (ESAS). J Trauma Acute Care Surg, 2016, 81(2): 213-220.
19.	Gaitanidis A, Mikdad S, Breen K, et al. The Emergency Surgery Score (ESS) accurately predicts outcomes in elderly patients undergoing emergency general surgery. Am J Surg, 2020, 220(4): 1052-1057.
20.	朱明华, 张珂诚, 唐云. 老年外科病人器官功能评估与优化. 中国实用外科杂志, 2021, 41(2): 231-235.
21.	郑波波, 胡涛, 邓祥兵, 等. MDT在同时性直肠癌肝转移的临床病例实践. 中国普外基础与临床杂志, 2018, 25(3): 342-349.
22.	伍晓汀. 老年外科手术患者的营养问题. 中国普外基础与临床杂志, 2004, 11(2): 182-184.
23.	World Health Organization. World report on ageing and health, 2015. https://apps.who.int/iris/handle/10665/186463.

1. Xu D, Hou L, Zhou H. Challenges faced by acute care surgeons in China. World J Emerg Surg, 2019, 14: 16. doi: 10.1186/s13017-019-0236-3.
2. 宁吉喆. 第七次全国人口普查主要数据情况. 中国统计, 2021, 5: 4-5.
3. World Health Organization. Populations are getting older. 12 February 2020. https://www.who.int/multi-media/details/populations-are-getting-older.
4. 国家卫生健康委员会. 中国卫生健康统计年鉴（2020）. 中国协和医科大学出版社, 2020: 122-126.
5. Xu D, Yin Y, Hou L, et al. A special acute care surgery model for dealing with dilemmas involved in emergency department in China. Sci Rep, 2021, 11(1): 1723. doi: 10.1038/s41598-021-81347-9.
6. Mayumi T, Yoshida M, Tazuma S, et al. The Practice Guidelines for Primary Care of Acute Abdomen 2015. Jpn J Radiol, 2016, 34(1): 80-115.
7. 吴海华. 多层螺旋CT在诊断老年急腹症中的临床应用价值及检出率分析. 影像研究与医学应用, 2021, 5(3): 213-214.
8. Falch C, Vicente D, Haberle H, et al. Treatment of acute abdominal pain in the emergency room: a systematic review of the literature. Eur J Pain, 2014, 18(7): 902-913.
9. 北京大学医学部急诊医学学系. 成人非创伤性急腹症早期镇痛专家共识. 中国急救医学, 2021, 41(1): 11-17.
10. 周凤刚. 急腹症的病情判断和动态观察. 中国普外基础与临床杂志, 2009, 16(8): 665-666.
11. 吴国豪. 重视老年普通外科病人围手术期处理. 中国实用外科杂志, 2009, 29(2): 109-111.
12. Ochsher A. Is risk of operation too great in the elderly? Geriatrics, 1967, 22（11）: 121-130.
13. Brooks B. Surgery in patients of advanced age. Ann Surg, 1937, 105(4): 481-495.
14. Wheatley BJ, Gorsuch JM, Mansour MA, et al. Vascular procedures in nonagenarians and centenarians are safe. Am J Surg, 2011, 201(3): 301-304.
15. 陈丹丹, 王杭芳. 老年肠梗阻患者急诊手术的临床特点. 中国老年学杂志, 2013, 33(22): 5750-5751.
16. Hentati H, Salloum C, Caillet P, et al. Risk factors for mortality and morbidity in elderly patients presenting with digestive surgical emergencies. World J Surg, 2018, 42(7): 1988-1996.
17. Li HX, Xue FS, Liu YY. Letter to the editor: Risk factors for mortality and morbidity in elderly patients presenting with digestive surgical emergencies. World J Surg, 2018, 42(12): 4127-4128.
18. Sangji NF, Bohnen JD, Ramly EP, et al. Derivation and validation of a novel Emergency Surgery Acuity Score (ESAS). J Trauma Acute Care Surg, 2016, 81(2): 213-220.
19. Gaitanidis A, Mikdad S, Breen K, et al. The Emergency Surgery Score (ESS) accurately predicts outcomes in elderly patients undergoing emergency general surgery. Am J Surg, 2020, 220(4): 1052-1057.
20. 朱明华, 张珂诚, 唐云. 老年外科病人器官功能评估与优化. 中国实用外科杂志, 2021, 41(2): 231-235.
21. 郑波波, 胡涛, 邓祥兵, 等. MDT在同时性直肠癌肝转移的临床病例实践. 中国普外基础与临床杂志, 2018, 25(3): 342-349.
22. 伍晓汀. 老年外科手术患者的营养问题. 中国普外基础与临床杂志, 2004, 11(2): 182-184.
23. World Health Organization. World report on ageing and health, 2015. https://apps.who.int/iris/handle/10665/186463.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Some problems worthy of attention in surgical diagnosis and treatment of elderly patients with acute abdomen

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