Changes in hospitalisation and surgical procedures among the oldest-old: a follow-up study of the entire Danish 1895 and 1905 cohorts from ages 85 to 99 years
Age and Ageing, 42:4, 476–481 (2013)
Objective. To examine whether the Danish 1905 cohort members had more active hospital treatment than the 1895 cohort members from ages 85 to 99 years and whether it result in higher in-hospital and post-operative mortality.
Methods. In the present register-based follow-up study the complete Danish birth cohorts born in 1895 (n=12,326) and 1905 (n=15,477) alive and residing in Denmark at age 85 were followed from ages 85 to 99 years with regard to hospitalizations and all-cause and cause-specific surgical procedures, as well as in-hospital and post-operative mortality.
Results. The 1905 cohort members had more frequent hospital admission and operations, but they had shorter length of hospital stay than the 1895 cohort at all ages from 85 to 99 years. The increase in primary prosthetic replacements of hip joint was observed even within the 1895 cohort: no patients were operated at ages 85-89 years versus 2.2 - 3.6% at ages 95-99 years. Despite increased hospitalization and operation rates, there was no increase in post-operative and in-hospital mortality rates in the 1905 cohort. These patterns were similar among men and women.
Conclusions. The observed patterns are compatible with more active treatment of the recent cohorts of old-aged persons and reduced age inequalities in the Danish healthcare system. No increase in post-operative mortality suggests that the selection of older patients eligible for a surgical treatment is likely to be based on the health status of old-aged persons and the safety of surgical procedures rather than chronological age.
Keywords: Denmark, cohorts, hospitalization, old age, surgery, survival