A combination of the improved safety of anaesthesia and surgery for older people, and a general improvement in availability of surgical treatments in the NHS is likely to be the reasons why people undergoing surgery in England are getting older at a faster rate than the general population.
This is according to a new British Journal of Surgery analysis, led by senior author Professor Rupert Pearse of Queen Mary University of London’s William Harvey Research Institute.
In the analysis of hospital records in England, the number of people aged 75 years or older undergoing surgery increased from 544,998 in 1999 to 1,012,517 in 2015.The average age of patients undergoing surgery increased from 47.5 years in 1999 to 54.2 years in 2015. By contrast, the average age of the English population increased from 38.3 to 39.7 years.
If current trends persist, by 2030 more than 1.48 million people aged 75 years or older will have a surgical procedure each year. This represents one in ten people in England and one in five people among those aged 75 years or older. Conservative estimates suggest that these operations will cost in excess of €3.2 billion.
Because advancing age is linked with a higher risk of complications and death after surgery, the findings indicate that healthcare policies must adapt to ensure that surgical treatments remain safe and sustainable as the surgical population ages. Also, a public debate about the risks and benefits of some operations for elderly patients may be needed. Finally, there is no reason to think England is a special case, so it is likely these findings are relevant to other European countries.
"Older people are much more likely to experience complications after surgery but this risk is not always obvious to patients and doctors," said senior author Prof. Rupert M. Pearse, of Queen Mary. "As we offer surgery more often to older patients, we may find the complications outweigh the benefits in many cases.
“We do need to plan more carefully for the needs of older people having surgery, and if this is going to be more common we need the right facilities in place in our hospitals to make sure the surgery is safe.
“We know that older patients with multiple medical problems think differently about the risks and benefits of surgery. We need to make sure these views are taken into account when doctors and patients discuss surgical treatments”.
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