Ahmet Gürkan ERDEMİR, Ayşenur BOLUKÇU, Esra AKÇİÇEK, Gökhan KAHRAMAN, Ali BATUR, İlkay Sedakat İDİLMAN, Mehmet Ruhi ONUR, Erhan AKPINAR
Türk Geriatri Dergisi - 2026;29(1):74-85
Introduction: With nonagenarians (>=90 years) increasingly presenting with non-traumatic acute abdomen, evidence on CT-based etiologies and short-term outcomes remains scarce, underscoring the need for focused data. To evaluate the etiological distribution and short-term mortality in nonagenarians undergoing abdominopelvic CT for non-traumatic acute abdomen. Materials and Method: This retrospective study included patients aged 90-99 who underwent CT between January 2013 and September 2023. Radiological findings were classified into 12 etiological subgroups. Malignancy status and surgical or image-guided interventions were documented. Mortality was assessed at 24 hours, 7 days, and 30 days. Categorical comparisons used chi-square or Fisher's exact tests (p<0.05). Results: A total of 529 patients (mean age: 92.9 years) were analyzed; 55.4% (n=293) had positive CT findings, most frequently hepatopancreatobiliary (10.8%), vascular (10.4%), and intestinal obstruction/torsion (8.5%). Malignancy-related etiologies comprised 31.7% of positive cases. Surgical or interventional treatment was performed in 10.4% (n=55). Overall mortality was 1.5% at 24 hours, 6.2% at 7 days, and 18.3% at 30 days. One-month mortality was higher in patients with positive CT findings (27.3%) compared to negative (7.2%, p<0.001). Among positive cases, malignancy-related etiologies showed significantly increased 30-day mortality (49.5% vs. 17.0%, p<0.001). Patients undergoing intervention also had elevated mortality (43.6% vs. 23.5%, p=0.003). Mortality varied by etiology, with gastrointestinal bleeding, perforation, and vascular causes carrying the greatest risk (p<0.001). Conclusion: This cohort provides a comprehensive overview of CT-based etiologies and outcomes in nonagenarians with acute abdomen. Malignancy, certain etiologies, and the need for intervention were strongly linked with adverse prognosis.
