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.	寧吉喆. 第七次全國人口普查主要數據情況. 中國統計, 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.	國家衛生健康委員會. 中國衛生健康統計年鑒（2020）. 中國協和醫科大學出版社, 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.	吳海華. 多層螺旋CT在診斷老年急腹癥中的臨床應用價值及檢出率分析. 影像研究與醫學應用, 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.	北京大學醫學部急診醫學學系. 成人非創傷性急腹癥早期鎮痛專家共識. 中國急救醫學, 2021, 41(1): 11-17.
10.	周鳳剛. 急腹癥的病情判斷和動態觀察. 中國普外基礎與臨床雜志, 2009, 16(8): 665-666.
11.	吳國豪. 重視老年普通外科病人圍手術期處理. 中國實用外科雜志, 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.	陳丹丹, 王杭芳. 老年腸梗阻患者急診手術的臨床特點. 中國老年學雜志, 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.	朱明華, 張珂誠, 唐云. 老年外科病人器官功能評估與優化. 中國實用外科雜志, 2021, 41(2): 231-235.
21.	鄭波波, 胡濤, 鄧祥兵, 等. MDT在同時性直腸癌肝轉移的臨床病例實踐. 中國普外基礎與臨床雜志, 2018, 25(3): 342-349.
22.	伍曉汀. 老年外科手術患者的營養問題. 中國普外基礎與臨床雜志, 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. 寧吉喆. 第七次全國人口普查主要數據情況. 中國統計, 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. 國家衛生健康委員會. 中國衛生健康統計年鑒（2020）. 中國協和醫科大學出版社, 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. 吳海華. 多層螺旋CT在診斷老年急腹癥中的臨床應用價值及檢出率分析. 影像研究與醫學應用, 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. 北京大學醫學部急診醫學學系. 成人非創傷性急腹癥早期鎮痛專家共識. 中國急救醫學, 2021, 41(1): 11-17.
10. 周鳳剛. 急腹癥的病情判斷和動態觀察. 中國普外基礎與臨床雜志, 2009, 16(8): 665-666.
11. 吳國豪. 重視老年普通外科病人圍手術期處理. 中國實用外科雜志, 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. 陳丹丹, 王杭芳. 老年腸梗阻患者急診手術的臨床特點. 中國老年學雜志, 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. 朱明華, 張珂誠, 唐云. 老年外科病人器官功能評估與優化. 中國實用外科雜志, 2021, 41(2): 231-235.
21. 鄭波波, 胡濤, 鄧祥兵, 等. MDT在同時性直腸癌肝轉移的臨床病例實踐. 中國普外基礎與臨床雜志, 2018, 25(3): 342-349.
22. 伍曉汀. 老年外科手術患者的營養問題. 中國普外基礎與臨床雜志, 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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