Sven Peterss1,2, Ahmed M Mansour1, Mohammad A Zafar1, Kabir Thombre1, John A Rizzo1,3, Bulat A Ziganshin1,4, Umer M Darr5, John A Elefteriades1. 1. Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA. 2. Department of Cardiac Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany. 3. Department of Economics and Department of Preventive Medicine, Stony Brook University, Stony Brook, NY, USA. 4. Department of Surgical Disease #2, Kazan State Medical University, Kazan, Russia. 5. Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA.
Abstract
OBJECTIVES: The objective of this study is to retrospectively analyse surgical outcomes in patients aged 75-79, and 80 and above. METHODS: Between 2000 and 2015, 108 patients aged 75-79 (G 75 , mean age 76.9 ± 1.5years) and 72 patients aged 80 and above (G 80 , mean age 82.2 ± 2.1years) underwent elective aneurysm repair. Operative outcome and survival was compared with 727 contemporary younger counterparts aged <75 years (G Ctrl , mean age 56.6 ± 11.7years). RESULTS: Postoperatively, patients with advanced age showed a higher incidence of prolonged ventilation (G 80 21.4%, G 75 8.4%, G Ctrl 2.9%; P < 0.001), low cardiac output syndrome (G 80 11.4%, G 75 1.9%, G Ctrl 2.2%; P = 0.001), multi organ failure (G 80 2.9%, G 75 0%, G Ctrl 0.1%; P = 0.022), haemofiltration (G 80 8.6%, G 75 0.9%, G Ctrl 0.6%; P < 0.001), and infection (G 80 10.0%, G 75 6.5%, G Ctrl 3.5%; P = 0.017). Operative mortality was significantly increased in the elderly (G 80 11.1%, G 75 3.7%, G Ctrl 1.4%; P < 0.001). Mid-term survival differed significantly between the surgical groups. Multivariate regression analysis precluded age as an independent predictor of operative mortality. CONCLUSIONS: Elderly patients showed a higher operative risk compared to their younger counterparts. However, age per se is no suitable indicator of surgical risk and well-selected patients with large threatening aneurysms may benefit from intervention.
OBJECTIVES: The objective of this study is to retrospectively analyse surgical outcomes in patients aged 75-79, and 80 and above. METHODS: Between 2000 and 2015, 108 patients aged 75-79 (G 75 , mean age 76.9 ± 1.5years) and 72 patients aged 80 and above (G 80 , mean age 82.2 ± 2.1years) underwent elective aneurysm repair. Operative outcome and survival was compared with 727 contemporary younger counterparts aged <75 years (G Ctrl , mean age 56.6 ± 11.7years). RESULTS: Postoperatively, patients with advanced age showed a higher incidence of prolonged ventilation (G 80 21.4%, G 75 8.4%, G Ctrl 2.9%; P < 0.001), low cardiac output syndrome (G 80 11.4%, G 75 1.9%, G Ctrl 2.2%; P = 0.001), multi organ failure (G 80 2.9%, G 75 0%, G Ctrl 0.1%; P = 0.022), haemofiltration (G 80 8.6%, G 75 0.9%, G Ctrl 0.6%; P < 0.001), and infection (G 80 10.0%, G 75 6.5%, G Ctrl 3.5%; P = 0.017). Operative mortality was significantly increased in the elderly (G 80 11.1%, G 75 3.7%, G Ctrl 1.4%; P < 0.001). Mid-term survival differed significantly between the surgical groups. Multivariate regression analysis precluded age as an independent predictor of operative mortality. CONCLUSIONS: Elderly patients showed a higher operative risk compared to their younger counterparts. However, age per se is no suitable indicator of surgical risk and well-selected patients with large threatening aneurysms may benefit from intervention.