Advertisement

Urgent Surgery in a Near Supercentenarian Nursing Home Resident: Possible With Favorable Outcome!

      We report our experience with an African American female from a Bronx nursing home who presented at the emergency room of our university hospital 10 days before she turned 110 years and underwent successful urgent surgery for gangrene from vascular disease in the lower extremity. The resident had fever and discoloration with discharge from the lower left leg of a week plus duration. The nursing home records indicated that the resident had earlier received oral antibiotics (ciprofloxin and metronidazole) for left lower extremity swelling and redness with poor response. The leg became blacker and her temperature exceeded 103°F.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hamel M.B.
        • Henderson W.G.
        • Khuri S.F.
        • et al.
        Surgical outcome for patients aged 80 and older: Morbidity and mortality from major noncardiac surgery.
        J Am Geriatr Soc. 2005; 53: 424-429
        • Dharmarajan T.S.
        • Unnikrishnan D.
        • Dharmarajan L.
        Perioperative medical management.
        in: Dharmarajan T.S. Norman R.A. Clinical Geriatrics. CRC Press/Parthenon Publishing, Boca Raton (FL)2003: 115-126
        • Turrentine F.E.
        • Wang H.
        • Simpson V.B.
        • et al.
        Surgical risk factors, morbidity, and mortality in elderly patients.
        J Am Coll Surg. 2006; 203: 865-877
        • Liu L.L.
        • Leung J.M.
        Predicting adverse postoperative outcomes in patients aged 80 years or older.
        J Am Geriatr Soc. 2000; 48: 405-412
        • Katlic M.R.
        Surgery in centenarians.
        JAMA. 1985; 253: 3139-3141
        • Forster M.C.
        • Calthorpe D.
        Mortality following surgery for proximal femoral fractures in centenarians.
        Injury. 2000; 31: 537-539
      1. Dharmarajan TS. Octogenarians, nonagenarians and even centenarians starting dialysis: Survival or withdrawal? Ann Intern Med 2007, electronic letter, published March 1, 2007. Avaliable at: http://www.annals.org/cgi/eletters/146/3/177. Accessed March 4, 2007.

        • Eagle K.A.
        • Berger P.B.
        • Calkins H.
        • et al.
        ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
        J Am Coll Cardiol. 2002; 39: 542-553
        • Fleisher L.A.
        • Beckman J.A.
        • Brown K.A.
        • et al.
        ACC/AHA 2006 guideline update on perioperative cardiovascular evaluation for noncardiac surgery: Focused update on perioperative beta-blocker therapy.
        Circulation. 2006; 113: 2662-2674
        • Davenport D.L.
        • Bowe E.A.
        • Henderson W.G.
        • et al.
        National Surgical Quality Improvement Program (NSQIP) risk factors can be used to validate American Society of Anesthesiologists Physical Status Classification (ASA PS) levels.
        Ann Surg. 2006; 243: 636-644
        • Polanczyk C.A.
        • Marcantonia E.
        • Goldman L.
        • et al.
        Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery.
        Ann Intern Med. 2001; 134: 637-643
        • Harari D.
        • Hopper A.
        • Dhesi J.
        • et al.
        Proactive care of older people undergoing surgery (‘POPS’): Designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients.
        Age Ageing. 2007; 36: 190-196