Background

The global elderly population is increasing rapidly, resulting in a growing number of older adults undergoing surgical procedures. Elderly patients are at higher risk of postoperative complications and mortality due to age-related physiological decline, frailty, multiple comorbidities, and reduced functional reserve. Identifying predictors of postoperative mortality is crucial for risk stratification, perioperative optimization, and improved clinical outcomes.

Objective

This study aimed to identify clinical, demographic, and perioperative predictors associated with postoperative mortality among elderly surgical patients.

Methods

A retrospective cohort study was conducted involving 1,200 patients aged 65 years and older who underwent major surgical procedures. Demographic variables, comorbidities, laboratory findings, surgical characteristics, and postoperative complications were analyzed. Multivariate logistic regression was used to identify independent predictors of postoperative mortality.

Results

The overall postoperative mortality rate was 8.7%. Independent predictors included advanced age (>80 years), frailty, high American Society of Anesthesiologists (ASA) score, emergency surgery, chronic kidney disease, postoperative sepsis, and prolonged intensive care unit (ICU) admission. Frailty was identified as the strongest predictor of mortality (OR = 3.8; 95% CI: 2.5–5.7).

Conclusion

Postoperative mortality in elderly patients is influenced by multiple clinical and perioperative factors. Early identification of high-risk individuals and implementation of targeted perioperative interventions may reduce mortality and improve surgical outcomes.