1 3 DOI 10.1007/s00068-015-0517-9 Eur J Trauma Emerg Surg ORIGINAL ARTICLE The outcomes of the elderly in acute care general surgery E. St-Louis 1 · M. Sudarshan 1 · M. Al-Habboubi 1 · M. El-Husseini Hassan 1 · D. L. Deckelbaum 1 · T. S. Razek 1 · L. S. Feldman 1 · K. Khwaja 1 Received: 13 December 2014 / Accepted: 11 March 2015 © Springer-Verlag Berlin Heidelberg 2015 for continuous variables and Fisher’s exact test for categor- ical variables using STATA 12 (College Station, TX, USA). Results We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (p < 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (p < 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (p = 0.05), increased postoperative complications (p = 0.002), admis- sion to the ICU (p = 0.002), and were more likely to receive a non-operative procedure (p = 0.003). No dif- ference was found (p = NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition. Conclusions Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital. Keywords Elderly · Octogenarian · Emergency general surgery · Outcomes · Age Background Western society is undergoing a significant demographic trend toward aging of its population, owing to decreased birth rates and increased longevity. In Canada, the percent- age of people aged greater than 65 years increased from 13 to 14.8 % between 2006 and 2011 [1, 2]. Currently, octoge- narians make up more than 4 % of the Canadian population [2]. The growing proportion of elderly citizens in the popu- lation is a phenomenon witnessed not only in North Amer- ica but also in Europe and Asia [1, 2]. This observation is the result of more sophisticated and accessible medical Abstract Introduction Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective proce- dures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care sur- gery patients >80 years old. Methods A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were stud- ied. Data analysis was completed with the Student’s t test * E. St-Louis etienne.st-louis@mail.mcgill.ca M. Sudarshan monisha.sudarshan@mail.mcgill.ca M. Al-Habboubi dr.safsaf@gmail.com M. El-Husseini Hassan mo.elhusseini@gmail.com D. L. Deckelbaum dan.deckelbaum@mcgill.ca T. S. Razek tarek.razek@mcgill.ca L. S. Feldman liane.feldman@mcgill.ca K. Khwaja kosar.khwaja@mcgill.ca 1 Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC H3G 1A4, Canada