Surgery Later in Life: Pros and Cons

Surgery, no matter how young and otherwise healthy you are, always carries a certain amount of risk. But when you're at an advanced age, surgery may in many cases be downright dangerous. Nevertheless, more and more surgeons are performing operations on people who are well into old age. Is there a point at which it's simply too late?

The medical community falls on both sides of the fence when it comes to this question.

Proponents of surgery for the very old point to some recent successes:

  • a pacemaker and defibrillator implanted in a woman shortly before her 100th birthday, enabling her to live six more years in relative good health
  • heart surgery performed without the benefit of heart and lung bypass machine on a 94-year-old woman
  • aortic valve replacement in a 97-year-old man.

One doctor explained that those who reach the upper limits of old age have extraordinary survival prowess, a factor that could make them good candidates for surgery.

Other doctors are less sanguine about the prospect of operating on an elderly patient. In fact, at some hospitals, people past a certain age may be refused surgery.

Researchers at the Duke Clinical Research Institute looked at surgical records from a single care center and found that heart surgery on people who were at least 80 years old resulted in much higher rates of death, repeated surgeries, kidney failure, and neurological difficulties than surgeries performed on younger patients.

A study by the Agency for Healthcare Research and Quality found that noncardiac surgery on the elderly also carries higher risks. For example, older people having knee-replacement surgery are at greater risk of pulmonary edema, heart attack, disturbed heart rhythms, pneumonia, respiratory failure, and death.

Nevertheless, for many older people, having surgery can restore a quality of life that had previously been impaired. And if the only alternative to surgery is death, physicians may be persuaded to perform it. As more and more people make it to the farthest reaches of old age, and as scientists continue to make medical breakthroughs that may render surgery safer, there should be ample opportunity to test the waters.


The New York Times,

Agency for Healthcare Research and Quality,

Jonathan E. E. Yager and Eric D. Peterson. "Cardiac Surgery in Octogenarians: Have We Gone Too Far...Or Not Far Enough?" American Heart Journal 147 (2004): 187-189. Print.