ACUTE ABDOMEN IN THE OLDEST-OLD: ETIOLOGIES AND MORTALITY OUTCOMES IN NONAGENARIANS

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ERDEMİR A. G., Bolukçu A., AKÇİÇEK E., KAHRAMAN G., BATUR A., İDİLMAN İ. S., ...Daha Fazla

Turk Geriatri Dergisi, cilt.29, sa.1, ss.74-85, 2026 (SCI-Expanded, SSCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.29400/tjgeri.2026.480
  • Dergi Adı: Turk Geriatri Dergisi
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, EMBASE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.74-85
  • Anahtar Kelimeler: Abdomen, Acute, Aged, 80 and Over, Emergency Medical Services, Mortality, Multidetector Computed Tomography
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Introduction: With nonagenarians (≥90 years) increasingly presenting with non-traumatic acute abdomen, evidence on CT-based etiologies and short-term outcomes remains scarce, underscoring the need for focused data. To evaluate the etiological distribution and short-term mortality in nonagenarians undergoing abdominopelvic CT for non-traumatic acute abdomen. Materials and Method: This retrospective study included patients aged 90– 99 who underwent CT between January 2013 and September 2023. Radiological findings were classified into 12 etiological subgroups. Malignancy status and surgical or image-guided interventions were documented. Mortality was assessed at 24 hours, 7 days, and 30 days. Categorical comparisons used chi-square or Fisher’s exact tests (p<0.05). Results: A total of 529 patients (mean age: 92.9 years) were analyzed; 55.4% (n=293) had positive CT findings, most frequently hepatopancreatobiliary (10.8%), vascular (10.4%), and intestinal obstruction/torsion (8.5%). Malignancy-related etiologies comprised 31.7% of positive cases. Surgical or interventional treatment was performed in 10.4% (n=55). Overall mortality was 1.5% at 24 hours, 6.2% at 7 days, and 18.3% at 30 days. One-month mortality was higher in patients with positive CT findings (27.3%) compared to negative (7.2%, p<0.001). Among positive cases, malignancy-related etiologies showed significantly increased 30-day mortality (49.5% vs. 17.0%, p<0.001). Patients undergoing intervention also had elevated mortality (43.6% vs. 23.5%, p=0.003). Mortality varied by etiology, with gastrointestinal bleeding, perforation, and vascular causes carrying the greatest risk (p<0.001). Conclusion: This cohort provides a comprehensive overview of CT-based etiologies and outcomes in nonagenarians with acute abdomen. Malignancy, certain etiologies, and the need for intervention were strongly linked with adverse prognosis.