İsmail Tırnova, Ahmet Serdar Karaca
Comprehensive Medicine - 2025;17(4):317-322
Objective: Emergency gastrointestinal surgery carries high postoperative complication and mortality rates, particularly in geriatric patients. Unlike elective procedures, limited preoperative optimization and frequent intraoperative contamination contribute to poorer outcomes. With the global increase in the geriatric population, understanding age-related risks is essential. This study aimed to compare early postoperative outcomes and etiological factors between adult and geriatric patients undergoing emergency laparotomy or laparoscopy. Materials and Methods: We retrospectively reviewed adult patients undergoing emergency general surgery between November 2021 and May 2025. Trauma cases, acute appendicitis, cholecystitis, and negative explorations were excluded. Demographics, comorbidities, preoperative laboratory values, surgical indications, techniques, ICU needs, complications, length of stay, and 30-day mortality were recorded. Patients were divided into adults (18-64 years) and geriatrics (>=65 years). Postoperative complications were evaluated using Clavien-Dindo and Comprehensive Complication Index (CCI) scores. Multivariate logistic regression was used to identify predictors of 30-day mortality. Results: Sixty patients were included (39 geriatric). Geriatric patients had higher ASA scores, more comorbidities, and lower preoperative albumin levels. Surgical indications, techniques, complication rates, and length of stay were similar between groups. Thirty-day mortality occurred in nine geriatric patients (15%), with low albumin identified as the only independent predictor. Conclusion: Advanced age alone did not independently influence postoperative outcomes, while low serum albumin significantly affected 30-day mortality. Emergency surgical care should focus on individualized management considering patient comorbidities, nutritional status, and etiology rather than age. Future multicenter studies are needed to refine risk stratification and optimize postoperative care. Keywords: EMERGENCY SURGERY, GERIATRICS, LAPAROSCOPY, LAPAROTOMY
