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Abdominal aortic aneurysm in the elderly

T A Salerno, P Hermandez, R B Lynn

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |January 1, 1981
    PubMed
    Summary
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    This study found that while abdominal aneurysm resection in patients 78 and older has a high overall mortality (46%), age itself is not a deterrent. Survival rates after surgery compare favorably to the general population.

    Area of Science:

    • Vascular Surgery
    • Geriatric Medicine
    • Cardiovascular Research

    Background:

    • Abdominal aortic aneurysms (AAAs) pose a significant risk, particularly in elderly populations.
    • Surgical intervention for AAAs in patients aged 78 and older is complex and carries inherent risks.

    Purpose of the Study:

    • To evaluate the outcomes of abdominal aneurysm resection in elderly patients (78+ years).
    • To determine the impact of age, aneurysm status (intact vs. ruptured), and comorbidities on surgical mortality and survival.

    Main Methods:

    • Retrospective analysis of 35 consecutive patients aged 78 and older undergoing AAA resection over 20 years.
    • Categorization of operations into elective and emergency, and by aneurysm status (intact or ruptured).
    • Life-table analysis to assess survival post-operation.

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    Main Results:

    • Overall mortality was 46%.
    • Mortality for intact aneurysms: 12.5% (elective) vs. 20% (emergency).
    • Mortality for ruptured aneurysms was significantly higher at 76.4%.
    • Mean survival for survivors was 48.6 months.
    • Factors increasing mortality included previous cardiac disease, aneurysm rupture, and severe blood loss.

    Conclusions:

    • Age alone is not a contraindication for abdominal aneurysm resection in elderly patients.
    • Surgical outcomes for abdominal aneurysms in this age group, when analyzed by life-table methods, are comparable to the general population.
    • Prompt intervention for intact aneurysms is associated with lower mortality compared to ruptured aneurysms.