Abstract

QUIROGA MERINO, Luis Ernesto; ESTRADA BRIZUELA, Yarima; PENA GALVAN, Liuba  and  GARCIA ALVAREZ, Pedro Julio. Influence of the immunologic presurgical state in elderly patients in the elective big surgery. AMC [online]. 2016, vol.20, n.6, pp. 648-659. ISSN 1025-0255.

Background: with the increase of age, immunologic changes that influence in a negative way in the result of surgery, which is an effect that has been increased with the rise of the life expectancy in Cuba. Objective: to determine the effect of the presurgical immunity in the result of the big elective surgery in elderly patients. Methods:  a prospective, longitudinal, analytic study was conducted. The universe was compound of 198 adults who underwent elective surgery. The non-probabilistic sample was composed of 153 patients that went through big elective surgery in Octavio of the Concepción and the Pedraja hospital in Camagüey. The information obtained from interviews with the patients and revision of the medical record and anesthetic report were gathered in a form created due to the research. Results: the immunologic state was normal in most of the patients, surgical mortality increased in those patients with immunodeficiency both humoral and cellular. Female sex prevailed with arterial hypertension and low weight, all evaluated of ASA III, who underwent surgery due to inguinal hernias. Complications increased significantly in patients with immunodeficiency. Conclusions: the immunologic state was normal in most of the patients; surgical mortality increased in those patients with immunodeficiency both humoral and cellular. Surgical mortality occurred in younger age groups in patients with poor presurgical immunity. Female patients prevailed, as well as arterial hypertension and low weight. Low weight was associated with surgical mortality in patients with immunology problems. Most of them were evaluated of ASA III, even though mortality was associated with ASA IV in both groups of patients. The association was bigger in the group that presented poor immunity. Complications increased in the patients with immunodeficiency, in which infections, xeroma and anemia were more frequent.

Keywords : IMMUNITY; INDICATORS OF MORBIDITY AND MORTALITY; SURGICAL PROCEDURES, OPERATIVE; AGED; LONGITUDINAL STUDIES.

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