Perioperative morbidity and mortality in elderly gynecological oncological patients (>=70 years) by the American Society of Anaesthesiology physical status classes

Background: We evaluated the morbidity and mortality associated with American Society of Anesthesiologists (ASA) classes III and IV versus ASA classes I and II in elderly women ( 70 years) undergoing gynecological oncological surgery. Methods: From 1986 to 2000, we retrospectively collected patients 70 years of age undergoing oncological gynecological surgery. The study population consisted of 121 ASA class III and IV patients. The control group consisted of the same number of patients with ASA classes I and II, and these were matched to study patients (1:1) by clinical and surgical data. The morbidity and mortality of patients with ASA status III and IV were analyzed before and after 1992. Results: In ASA class III and IV patients, compared with ASA class I and II, a higher rate of severe morbidity (P .000) occurred, whereas the median postoperative stay was similar (8 days). No differences between patients with ASA class III and IV and ASA class I and II for median operative time, transfusion rate, or median blood loss were found. Mortality was 3% in ASA classes III and IV. Conclusions: Our study suggests that surgery in elderly gynecological oncological patients aged 70 years with ASA class III or IV results in an acceptable perioperative morbidity and mortality rate.