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Outcome After Ruptured AAA Repair in Octo- and Nonagenarians in Sweden 1994-2014
B Sonesson1, K Björses1, N Dias1
1Vascular Centre, Skåne University Hospital, Malmö, Sweden.
Summary
Ruptured abdominal aortic aneurysm repair in octogenarians and nonagenarians has a high early mortality rate. However, survivors experience surprisingly good long-term survival, comparable to the general population.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Public Health
Background:
- Ruptured abdominal aortic aneurysm (rAAA) repair outcomes in the elderly are critical.
- Octogenarians and nonagenarians represent a growing demographic undergoing complex vascular procedures.
Purpose of the Study:
- To analyze the outcomes of ruptured abdominal aortic aneurysm (rAAA) repair in patients aged 80 and older.
- To compare survival rates between open repair (OR) and endovascular aneurysm repair (EVAR) in this elderly cohort.
Main Methods:
- Retrospective analysis of the Swedish Vascular Registry (1994-2014).
- Inclusion of 1538 patients with rAAA aged 80+.
- Kaplan-Meier survival analysis (crude, long-term, relative) and multivariate Cox regression.
Main Results:
- Crude 90-day survival after rAAA repair was 50%.
- Long-term survival after surviving the initial 90 days was 53% at 5 years.
- Endovascular aneurysm repair (EVAR) showed better crude survival than open repair (OR).
Conclusions:
- High peri-operative mortality exists for rAAA repair in octo- and nonagenarians.
- Long-term survival for rAAA survivors in this cohort is favorable.
- EVAR may offer survival benefits over OR in this age group.
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