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J R Soc Med 2001;94:232-235
© 2001 Royal Society of Medicine

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J R Soc Med 2001;94:232-235
© 2001 The Royal Society of Medicine

Surgical decisions in the elderly: the importance of biological age

S M Farquharson FRCS   Ramesh Gupta FRCS   R J Heald MChir FRCS     B J Moran MCh FRCSI  

Colorectal Research Unit, North Hampshire Hospital, Basingstoke, Hampshire RG24 9NA, UK

Correspondence to: Miss M Farquharson FRCS

Surgeons will sometimes advise against an operation because the patient is ‘old and frail’. A simple starring system (one to five), based on performance and lifestyle, has been devised to assess the biological age of elderly patients. 10 consultant surgeons and 10 trainees answered questions about their treatment recommendations for hypothetical patients of standard age and medical history but with various star ratings and surgical conditions. 1000 decisions were available for analysis.

The four and five star patients (those leading an independent existence) were recommended 266 interventions, the one and two star patients 55. Trainees were more inclined to intervene than consultants, recommending operations in half the patients rather than one-third.

These results indicate that decisions on surgical management are strongly influenced by the patient's star rating or biological age. If the starring method proves reproducible in other patient groups and settings, it could allow better communication on an important factor in clinical decisions.


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