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Abdominal aortic aneurysm in the elderly

R T Chalmers1, P A Stonebridge, T G John

  • 1Vascular Surgery Unit, Royal Infirmary, Edinburgh, UK.

The British Journal of Surgery
|September 1, 1993
PubMed
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Elderly patients over 80 undergoing abdominal aortic aneurysm surgery face higher mortality, especially with ruptures. Elective surgery in this age group has a zero mortality rate, highlighting the importance of timely intervention.

Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Public Health

Background:

  • Abdominal aortic aneurysm (AAA) repair is a common vascular procedure.
  • Outcomes for elderly patients undergoing AAA repair are critical due to demographic shifts.
  • Surgical intervention for AAA, particularly in the elderly, requires careful risk-benefit analysis.

Purpose of the Study:

  • To evaluate the outcomes of surgical repair for abdominal aortic aneurysm in patients over 80 years old.
  • To compare mortality rates between ruptured and non-ruptured AAA in the elderly.
  • To assess the impact of age on AAA surgical intervention acceptance and outcomes.

Main Methods:

  • Retrospective analysis of 35 patients aged over 80 undergoing AAA surgery between 1985 and 1990.

Related Experiment Videos

  • Categorization of patients into ruptured and non-ruptured (symptomatic/asymptomatic) AAA groups.
  • Prospective analysis of all AAA referrals, including those not operated on.

    • Main Results:

    • Mortality rate for ruptured AAA in patients over 80 was 56%, significantly higher than the 36% in those under 80.
    • Elective AAA surgery in patients over 80 had a zero mortality rate, contrasting with 5% in younger patients.
    • Patients over 80 were less likely to be accepted for surgery (12:34 ratio) compared to younger patients (92:59 ratio).

    Conclusions:

    • Surgical intervention for abdominal aortic aneurysm in patients over 80 carries a high risk when the aneurysm has ruptured.
    • Elective surgery for abdominal aortic aneurysm in the elderly population demonstrates excellent outcomes with zero mortality.
    • Age is a significant factor influencing the decision to operate on patients with abdominal aortic aneurysm, with elderly patients being referred for surgery less frequently.