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Endovascular Aortic...
Endovascular Aortic Repair in Nonagenarian Patients
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- Prendes, Carlota F. (författare)
- Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Marchioninistr 15, D-81377 Munich, Germany
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- Dayama, Anand (författare)
- Eastern Virginia Med Sch, Div Vasc Surg, Norfolk, VA 23501 USA.
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- Panneton, Jean M. (författare)
- Hosp Univ Cent Asturias, Oviedo, Spain.
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- Stana, Jan (författare)
- Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Marchioninistr 15, D-81377 Munich, Germany.
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- Rantner, Barbara (författare)
- Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Marchioninistr 15, D-81377 Munich, Germany.
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- Álvarez Marcos, Francisco (författare)
- Hosp Univ Cent Asturias, Oviedo, Spain.
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- Mani, Kevin, 1975- (författare)
- Uppsala universitet,Kärlkirurgi
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- Wanhainen, Anders (författare)
- Uppsala universitet,Kärlkirurgi
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- Tsilimparis, Nikolaos (författare)
- Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Marchioninistr 15, D-81377 Munich, Germany.
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Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Marchioninistr 15, D-81377 Munich, Germany Eastern Virginia Med Sch, Div Vasc Surg, Norfolk, VA 23501 USA (creator_code:org_t)
- Elsevier, 2021
- 2021
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 77:15, s. 1891-1899
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BackgroundThe increasing proportion of elderly patients being treated for abdominal aortic aneurysm (AAA) in the endovascular era is controversial.ObjectivesThis study compared 30-day outcomes of endovascular aortic repair (EVAR) in nonagenarians (NAs) with non-nonagenarians (NNAs).MethodsThis retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database included EVAR procedures performed from 2011 to 2017. Multivariate logistic regression in the unadjusted cohort, followed by propensity-score matching (PSM), was performed. Primary outcomes were 30-day mortality and 30-day major adverse events.ResultsA total of 12,267 patients were included (365 NAs). Ruptured aneurysms accounted for 6.7% (n = 819): 15.7% (n = 57) in NAs versus 6.5% (n = 762) in NNAs (p < 0.001). Mean aneurysm diameter was 6.5 ± 1.8 cm in NAs versus 5.8 ± 1.7 cm in NNAs (p < 0.001). The unadjusted 30-day mortality was 9.9% in NA versus 2.2% in NNAs (p < 0.001). Multivariate analysis revealed age ≥90 years (odds ratio [OR]: 3.36), male sex (OR: 1.78), functional status (OR: 4.22), pre-operative ventilator dependency (OR: 3.80), bleeding disorders (OR: 1.52), dialysis (OR: 2.56), and ruptured aneurysms (OR: 17.21) as independent predictors of mortality. After PSM, no differences in 30-day mortality (intact AAA [iAAA]: 5.3% NA vs. 3% NNA [p = 0.15]; ruptured AAA [rAAA]: 38% NA vs. 28.6% NNA [p = 0.32]) or 30-day major adverse events (iAAA: 7% NA vs. 4.6% NNA [p = 0.22]; rAAA: 28% NA vs. 36.7% NNA [p = 0.35]) were observed.ConclusionsAge was identified as an independent predictor of 30-day mortality after EVAR on multivariate analysis. However, no differences were found after PSM, suggesting that being ≥90 years of age but with similar comorbidities to younger patients is not associated with a higher short-term mortality after EVAR. Age ≥90 years alone should not exclude patients from EVAR, and tailored indications and carefully balanced risk assessment are advised.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- elderly population
- endovascular aortic repair
- nonagenarians
- NSQIP
- ruptures
- aortic aneurysms
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Prendes, Carlota ...
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Dayama, Anand
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Panneton, Jean M ...
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Stana, Jan
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Rantner, Barbara
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Álvarez Marcos, ...
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Mani, Kevin, 197 ...
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Wanhainen, Ander ...
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Tsilimparis, Nik ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
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Uppsala universitet