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Increased mortality in octogenarians treated for lifestyle limiting claudication
Young Erben1, Carlos I Mena-Hurtado2, Samuel M Miller3
1Section of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
Summary
Octogenarians undergoing infra-inguinal interventions for lifestyle-limiting claudication (LLC) experience higher morbidity and mortality. Alternative treatments like medical management and supervised exercise therapy should be considered for this elderly group.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Interventional Cardiology
Background:
- Lifestyle-limiting claudication (LLC) is often treated with infra-inguinal bypass, angioplasty, or stenting.
- There is a growing trend towards endovascular interventions for LLC.
Purpose of the Study:
- To compare the outcomes of infra-inguinal interventions in octogenarians versus younger patients.
- To analyze morbidity, mortality, length of stay, and patient disposition.
Main Methods:
- Retrospective analysis of the Nationwide Inpatient Sample (2003-2012).
- Patients were divided into two cohorts: 60-80 years (younger) and >80 years (octogenarians).
- Primary endpoints: morbidity and mortality; Secondary endpoints: length of hospital stay (LOS) and disposition.
Main Results:
- Octogenarians had higher rates of acute kidney injury, congestive heart failure exacerbation, and mortality.
- Younger patients had a higher rate of infectious wound complications.
- Octogenarians experienced longer LOS and higher discharge rates to skilled nursing facilities.
Conclusions:
- Despite a shift towards endovascular treatment, octogenarians with LLC face significantly higher morbidity and mortality.
- Medical management and supervised exercise therapy warrant further investigation for octogenarian patients with LLC.
Keywords:
angiographyperipheral arterial diseaseperipheral interventionperipheral vascularperipheral/renalsurgeryMore Related Videos
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