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Infrainguinal reconstruction in octogenarians: should age be a contraindication?
D Choi1, R C Darling, S P Roddy
1Institute for Vascular Health and Disease, Albany Medical College, Albany, NY 12208, USA.
Annals of Vascular Surgery
|January 12, 2000
Summary
Elderly patients over 80 undergoing infrainguinal reconstruction have outcomes comparable to younger patients. Age should not be a contraindication for this vascular surgery, ensuring appropriate patient care.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Health Economics
Background:
- Increasing demand for elderly medical care due to population aging.
- Healthcare cost containment pressures leading to denial of expensive procedures.
- Infrainguinal reconstructions denied based on age alone at the institution.
Purpose of the Study:
- To evaluate outcomes of infrainguinal reconstruction in octogenarians (aged >80 years).
- To compare results of elderly patients with younger cohorts.
- To determine if age alone is a valid contraindication for infrainguinal reconstruction.
Main Methods:
- Retrospective review of 629 patients aged >80 years undergoing infrainguinal reconstruction (1989-1998).
- Comparison with 3257 patients <80 years old during the same period.
- Analysis of demographics, indications, and outcomes using Fisher's exact test and log rank analysis (p < 0.05).
Main Results:
- Indications differed: more limb salvage (older group) vs. claudication (younger group).
- Similar nonfatal complication rates between age groups.
- Comparable primary and secondary patency rates and limb salvage rates for both octogenarians and younger patients.
Conclusions:
- Octogenarians achieve outcomes comparable to younger patients undergoing infrainguinal reconstruction.
- Age should not be an absolute contraindication for infrainguinal arterial reconstruction.
- Healthcare resources can be effectively allocated to octogenarian patients for this procedure.