Age of patients undergoing surgery

Abstract

Background Advancing age is independently associated with poor post-operative outcomes. The ageing of the general population is a major concern for healthcare providers. We studied trends in age amongst patients undergoing surgery in the National Health Service in England. Methods Time trend ecological analysis of Hospital Episode Statistics and Office for National Statistics data for England from 1999 to 2015. We calculated the proportion of patients undergoing surgery in different age groupings, their pooled mean age, and change in age profile over time. We estimated growth in the surgical population, and associated costs, to the year 2030 using linear regression modelling. Results We identified 68,205,695 surgical patient episodes (31 220 341 males [45.7%]). The mean length of hospital stay was 5.3 days. The surgical population was older than the general population of England; this gap increased over time (1999: 47.5 vs. 38.3 years; 2015: 54.2 vs. 39.7 years). The number of people aged ≥75 years undergoing surgery increased from 544 998 (14.9% of population) in 1999 to 1 012 517 (22.9% of population) in 2015. By 2030, we estimate one fifth of the ≥75 years population age-group will undergo surgery each year (1.48 million people [95% CI: 1.43 – 1.55]) at a cost of £2.9 (2.8-3.1) billion ($3.8 billion USD). Conclusions The surgical population of England is ageing at a faster rate than the general population. Healthcare policies must adapt to ensure provision of surgical treatments remains safe and sustainable. A debate about the risks and benefits of surgery for elderly patients may be appropriate.