S Aune1. 1. Department of Surgery, Haukeland University Hospital, Bergen, 5021, Norway.
Abstract
OBJECTIVE: To report risk factors, early operative results and survival after repair of asymptomatic abdominal aortic aneurysm (AAA) in patients aged less than 66 years. DESIGN: a retrospective study based on a prospectively updated database in a University hospital. PATIENTS AND METHODS: Between 1985 and 1999, 118 patients of less than 66 years were operated for AAA. Pre-operative risk factors, early complications, operative mortality (<30 days), and survival are compared with that of 333 older patients operated during the same period. RESULTS: Risk factors were similar to older patients. Serious early (<30 days) complications were recorded in 20% of both groups. The operative mortality was 1.7% for the younger patients and 6% for the older (n.s.). The eight-year survival of the younger patients was 69%, which was significantly below that of a demographically matched population. The older patients had a significantly poorer eight-year survival of 47% (p<0.01), but their relative survival was significantly better (p<0.05). CONCLUSIONS: Younger patients with an AAA were not healthier than older patients. Complications were equally common among both groups. Although the operative mortality was lower, the long-term relative survival was poorer than that of the older patient. Present data do not support a more aggressive surgical attitude towards the younger patients with an asymptomatic abdominal aortic aneurysm, as compared to the older.
OBJECTIVE: To report risk factors, early operative results and survival after repair of asymptomatic abdominal aortic aneurysm (AAA) in patients aged less than 66 years. DESIGN: a retrospective study based on a prospectively updated database in a University hospital. PATIENTS AND METHODS: Between 1985 and 1999, 118 patients of less than 66 years were operated for AAA. Pre-operative risk factors, early complications, operative mortality (<30 days), and survival are compared with that of 333 older patients operated during the same period. RESULTS: Risk factors were similar to older patients. Serious early (<30 days) complications were recorded in 20% of both groups. The operative mortality was 1.7% for the younger patients and 6% for the older (n.s.). The eight-year survival of the younger patients was 69%, which was significantly below that of a demographically matched population. The older patients had a significantly poorer eight-year survival of 47% (p<0.01), but their relative survival was significantly better (p<0.05). CONCLUSIONS: Younger patients with an AAA were not healthier than older patients. Complications were equally common among both groups. Although the operative mortality was lower, the long-term relative survival was poorer than that of the older patient. Present data do not support a more aggressive surgical attitude towards the younger patients with an asymptomatic abdominal aortic aneurysm, as compared to the older.