当前位置： SCI文献检索 > ANNALS OF VASCULAR SURGERY期刊下所有文献 > The age effect in increasing operative mortality following delay in elective abdominal aortic aneurysm repair.

The age effect in increasing operative mortality following delay in elective abdominal aortic aneurysm repair.

Abstract：

BACKGROUND:Elective repair of large abdominal aortic aneurysms (AAAs) is associated with the risk of significant perioperative mortality. When abdominal aneurysm repair is delayed, patients with asymptomatic large AAAs face the risk of death from rupture. In addition to the risk of rupture, the advancing age of the patients adds a future operative risk. This risk has been historically documented in age groups. However, a more accurate representation of the increasing operative risk with age is needed. METHODS:We analyzed all patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent endovascular or open repair for asymptomatic infrarenal AAA between 2005 and 2012. Multivariable logistic regression was used to evaluate the effect of increasing age and operative delay on 30-day postoperative mortality. RESULTS:There were 27,576 patients who underwent AAA repair during the study period (mean age 73.5 years, standard deviation 8.6, 80% male, 24% open repair). There was a linear relative increase of 5% (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04-1.06, P < 0.001) in the odds of operative death after AAA repair with each year of operative delay irrespective of treatment approach. There was a linear relative increase of 4% for endovascular aneurysm repair (OR 1.04, 95% CI 1.02-1.05, P < 0.001) and 6% for open repair (OR 1.06, 95% CI 1.04-1.08, P < 0.001) with each year of delay in repair. CONCLUSIONS:Because of increasing age, delay in surgery is associated with uniform increase in the risk of perioperative mortality in asymptomatic patients who meet criteria for AAA repair. It is important for surgeons to incorporate this more accurate estimation of operative risk into discussions with patients who qualify for treatment yet decide to forgo surgery for the repair of their AAA.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Arhuidese IJ,Salami A,Obeid T,Qazi U,Abularrage CJ,Black JH,Perler B,Malas MB

doi

10.1016/j.avsg.2015.03.041

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

1181-7

issue

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(15)00334-9

journal_volume

pub_type

杂志文章

在线工具

The age effect in increasing operative mortality following delay in elective abdominal aortic aneurysm repair.