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Article: Predictors of early operative mortality and long-term survival in octogenarians undergoing open and endovascular repair of abdominal aortic aneurysm
Title | Predictors of early operative mortality and long-term survival in octogenarians undergoing open and endovascular repair of abdominal aortic aneurysm |
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Authors | |
Keywords | Abdominal aortic aneurysm Octogenarians Open repair Endovascular aneurysm repair Operative mortality |
Issue Date | 2018 |
Publisher | Elsevier: Creative Commons Attribution Non-Commercial No-Derivatives License. The Journal's web site is located at http://www.elsevier.com/wps/find/journaldescription.cws_home/708511/description#description |
Citation | Asian Journal of Surgery, 2018, v. 41 n. 5, p. 490-497 How to Cite? |
Abstract | Background:
The study aims to report outcomes of open repair (OR) and endovascular aneurysm repair (EVAR) in octogenarians.
Methods:
Consecutive patients aged between 80 and 89 who underwent OR or EVAR were identified from a prospectively collected departmental database. Short-term outcomes included 30 days mortalities and perioperative complications; long-term outcomes included overall survival and re-intervention using the Kaplan–Meier method. Logistic regression was used to identify predictors for operative mortality and Cox regression analysis was used to identify predictors for long-term survival.
Results:
From January 1999 to December 2013, 53 underwent open repairs (23 emergency and 30 elective) and 115 underwent endovascular repairs (11 emergency and 104 elective). For elective procedures, 30 days operative mortalities were 6.7% and 0% in OR and EVAR respectively (Chi square test, p = 0.049). For emergency procedures, 30 days mortalities were 39.1% and 27.2% respectively (Chi square test, p = 0.705). Overall 5 years survival rates were 40.4% and 36.7% after OR and EVAR respectively. Rupture of aneurysm (Odd ratio 18.8, 95% CI 3.4–104.5, p = 0.001) was the only predictor for 30 days mortality. Rupture of aneurysm (Hazard ratio 2.0, 95% CI 1.3–3.3, p = 0.003), history of lung disease (Hazard ratio 1.7, 95% CI 1.0–2.9, p = 0.039) and history of renal disease (Hazard ratio 2.1, 95% CI 1.4–3.1, p < 0.001) were independent predictors for long-term overall survival.
Conclusion:
Decision of AAA repair in octogenarians should not be based on age alone. Both elective OR and EVAR had acceptable perioperative risk, but emergency repair, lung disease and renal impairment predicted poor long-term survival. |
Persistent Identifier | http://hdl.handle.net/10722/271302 |
ISSN | 2023 Impact Factor: 3.5 2023 SCImago Journal Rankings: 0.538 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Law, Y | - |
dc.contributor.author | Chan, YC | - |
dc.contributor.author | Cheng, SWK | - |
dc.date.accessioned | 2019-06-24T01:07:15Z | - |
dc.date.available | 2019-06-24T01:07:15Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | Asian Journal of Surgery, 2018, v. 41 n. 5, p. 490-497 | - |
dc.identifier.issn | 1015-9584 | - |
dc.identifier.uri | http://hdl.handle.net/10722/271302 | - |
dc.description.abstract | Background: The study aims to report outcomes of open repair (OR) and endovascular aneurysm repair (EVAR) in octogenarians. Methods: Consecutive patients aged between 80 and 89 who underwent OR or EVAR were identified from a prospectively collected departmental database. Short-term outcomes included 30 days mortalities and perioperative complications; long-term outcomes included overall survival and re-intervention using the Kaplan–Meier method. Logistic regression was used to identify predictors for operative mortality and Cox regression analysis was used to identify predictors for long-term survival. Results: From January 1999 to December 2013, 53 underwent open repairs (23 emergency and 30 elective) and 115 underwent endovascular repairs (11 emergency and 104 elective). For elective procedures, 30 days operative mortalities were 6.7% and 0% in OR and EVAR respectively (Chi square test, p = 0.049). For emergency procedures, 30 days mortalities were 39.1% and 27.2% respectively (Chi square test, p = 0.705). Overall 5 years survival rates were 40.4% and 36.7% after OR and EVAR respectively. Rupture of aneurysm (Odd ratio 18.8, 95% CI 3.4–104.5, p = 0.001) was the only predictor for 30 days mortality. Rupture of aneurysm (Hazard ratio 2.0, 95% CI 1.3–3.3, p = 0.003), history of lung disease (Hazard ratio 1.7, 95% CI 1.0–2.9, p = 0.039) and history of renal disease (Hazard ratio 2.1, 95% CI 1.4–3.1, p < 0.001) were independent predictors for long-term overall survival. Conclusion: Decision of AAA repair in octogenarians should not be based on age alone. Both elective OR and EVAR had acceptable perioperative risk, but emergency repair, lung disease and renal impairment predicted poor long-term survival. | - |
dc.language | eng | - |
dc.publisher | Elsevier: Creative Commons Attribution Non-Commercial No-Derivatives License. The Journal's web site is located at http://www.elsevier.com/wps/find/journaldescription.cws_home/708511/description#description | - |
dc.relation.ispartof | Asian Journal of Surgery | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Abdominal aortic aneurysm | - |
dc.subject | Octogenarians | - |
dc.subject | Open repair | - |
dc.subject | Endovascular aneurysm repair | - |
dc.subject | Operative mortality | - |
dc.title | Predictors of early operative mortality and long-term survival in octogenarians undergoing open and endovascular repair of abdominal aortic aneurysm | - |
dc.type | Article | - |
dc.identifier.email | Law, Y: ylaw@hku.hk | - |
dc.identifier.email | Chan, YC: ycchan88@hkucc.hku.hk | - |
dc.identifier.email | Cheng, SWK: swkcheng@hku.hk | - |
dc.identifier.authority | Chan, YC=rp00530 | - |
dc.identifier.authority | Cheng, SWK=rp00374 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1016/j.asjsur.2017.09.004 | - |
dc.identifier.pmid | 29233598 | - |
dc.identifier.scopus | eid_2-s2.0-85037642936 | - |
dc.identifier.hkuros | 298107 | - |
dc.identifier.volume | 41 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 490 | - |
dc.identifier.epage | 497 | - |
dc.identifier.isi | WOS:000446398100014 | - |
dc.publisher.place | Hong Kong | - |
dc.identifier.issnl | 1015-9584 | - |