AIMS
We aim to compare explore peri-operative exposures, including pre-operative fasting durations and aspiration risk in older (≥65 years) and younger (<65) cohorts.
METHODS
A retrospective chart analysis of all patients undergoing surgery in February 2025 in a major tertiary hospital. Incomplete data sets were excluded.
RESULTS
Amongst 1719 undergoing surgery, 1534 (638 emergency cases) were included in this study. Overall, 50.3% of patients were ASA 3 or greater, median BMI was 28.14 (IQR 23.53-31.53), median age 58 (IQR 39-70), and 38 (2.5%) were on GLP1-RA. Median fasting time for solids was 15.35 hours (11.59-20.84), 10.51 hours (6.72-14.60) for liquids.
ASA classifications differed significantly between cohorts (p<0.001), with 72.3% of older patients being ASA 3 or higher compared with 37.8% in the younger group. A greater proportion of surgeries were elective (68% vs 53%, p<0.01). There was no notable difference between median fasting times for either solids or liquids between cohorts, nor between the incidence of GLP1-RA (p>0.05). No aspiration events during induction of anaesthesia, intraoperatively, or during recovery were noted.
CONCLUSIONS
Aspiration risk was low in this cohort, across age groups potentially highlighting safe multidisciplinary peri-operative management. Any association with GLP1-RA medications could not be excluded given the small numbers on same and lack of aspiration events. Older patients had a significantly higher ASA, underscoring the increased comorbidity they face. Both groups exceeded recommended fasting guidelines, demonstrating the need for concerted efforts to maximise nutrition, especially in older people who may be more vulnerable.