Your browser has javascript turned off or blocked. This will lead to some parts of our website to not work properly or at all. Turn on javascript for best performance.

The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

ludc webb

Nuno Dias

Associate professor

ludc webb

Outcome After Ruptured AAA Repair in Octo- and Nonagenarians in Sweden 1994-2014

Author

  • B. Sonesson
  • K. Björses
  • N. Dias
  • R. Rylance
  • K. Mani
  • A. Wanhainen
  • T. Resch

Summary, in English

Objective: To report the outcome after ruptured abdominal aortic aneurysm (rAAA) repair in octo- and nonagenarians from the Swedish Vascular Registry 1994-2014. Material and methods: 2335 intact AAA (iAAA) and 1538 rAAA were identified in patients aged 80 years and older. Crude, long-term, and relative survival data were analysed using the Kaplan-Meier method. Crude survival was calculated including all deaths. Long-term survival was analysed excluding AAA repair related mortality, defined as death within 90 days of surgery. Relative survival was assessed by comparing the observed long-term survival after AAA repair with the expected survival of a Swedish population adjusted for age, gender, and operation year. Differences were compared using log-rank tests. The multivariate Cox model was used for adjusting for confounding factors between open repair (OR) and endovascular aneurysm repair (EVAR). Results: Crude survival after rAAA repair was 30 days (55%), 90 days (50%), 1 year (45%), 5 years (26%), and 10 years (9%). Long-term survival was 1 year (90%), 5 years (53%), and 10 years (18%). When individuals with rAAA were categorized into males and females, crude and long-term survival showed no significant differences (p = .204 and p = .134). When rAAA patients were categorized into age groups (80-84 years, 85-89 years, 90+) crude survival diminished with increasing age, but long-term survival was not (p = .009 and p = .368). Compared with the general population, rAAA patients showed only a minor decrease in relative survival. Crude survival after rAAA was better for EVAR compared with OR (p = .007), hazard ratio 1.3 (95% CI 1.1-1.6, p < .012). Conclusions: There is a high (50%) peri-operative mortality after surgery for rAAA in octo- and nonagenarians, with no significant differences between the sexes and worse survival with increasing age. However, if a patient has survived the initial 90 days, long-term survival in this very old cohort is surprisingly good at more than 50% after 5 years, only slightly less than the general population.

Publishing year

2017-03-27

Language

English

Pages

656-662

Publication/Series

European Journal of Vascular and Endovascular Surgery

Volume

53

Issue

5

Document type

Journal article

Publisher

Elsevier

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Endovascular aneurysm repair
  • Octo- and nonagenarians
  • Open repair
  • Outcome
  • Ruptured abdominal aortic aneurysm

Status

Published

ISBN/ISSN/Other

  • ISSN: 1078-5884