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Age-stratified outcomes in elderly patients undergoing open and endovascular procedures for aortoiliac occlusive

Jeffrey E Indes1, Charles T Tuggle, Anant Mandawat

  • 1Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA. jeffrey.indes@yale.edu

Surgery
|June 29, 2010
PubMed

Insights

For elderly patients with aortoiliac occlusive disease (AIOD), endovascular treatment offers better outcomes than open procedures, especially for those aged 70 and older. This approach reduces complications, hospital stay, and costs.

Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Health Economics

Background:

  • Elderly patients represent a significant population affected by aortoiliac occlusive disease (AIOD).
  • Analysis of outcomes in elderly patients undergoing open and endovascular procedures for AIOD is crucial for optimizing care.

Purpose of the Study:

  • To compare the clinical and economic outcomes of open versus endovascular procedures for AIOD in elderly patients.
  • To stratify outcomes based on age groups within the elderly population.

Main Methods:

  • Retrospective analysis of elderly AIOD patients from the HCUP-NIS database (2004-2007).
  • Stratification into age groups: 65-69, 70-79, and 80+ years.
  • Comparison using chi(2), ANOVA, and multivariate regression for complications, mortality, duration of stay, and hospital cost.

Main Results:

  • Patients aged 80+ had higher rates of nonelective admissions, comorbidities, and iliac artery disease.
  • Open procedures in the 80+ group showed higher complication and mortality rates.
  • Endovascular procedures consistently demonstrated lower complication rates, shorter hospital stays, and reduced costs across all age groups.
  • Mortality was significantly lower with endovascular treatment in patients aged 70+.

Conclusions:

  • Clinical outcomes for both open and endovascular procedures for AIOD deteriorate with increasing patient age.
  • Endovascular treatment is associated with a lower complication rate compared to open repair in patients aged 70 years and older.
Abstract

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