ORIGINAL ARTICLES   

Giornale Italiano di Chirurgia Vascolare 1999 September;6(3):181-6

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English, Italian

The fate of octogenarian patients after abdominal aortic aneurysm. A retrospective study

Mainente A., Nano G., Tealdi D. G.

From the Department and Division of Vascular Surgery (Head: Prof. D. G. Tealdi) San Donato Hospital University of Milan, Milan, Italy

Background and ­aims. Owing to the ­increased ­mean ­life expec­tan­cy of the pop­u­la­tion, ­there is a ­rise in the diag­nos­tic inci­dence of aneu­rys­mat­ic pathol­o­gy in ­ultra-octo­ge­nar­ian ­patients.
Methods. The ­authors col­lect­ed ­data relat­ing to the inci­dence of aneu­rys­mat­ic pathol­o­gy in ­ultra-octo­ge­nar­ian ­patients ­over a 10-­year peri­od in ­order to eval­u­ate wheth­er the sur­gi­cal cor­rec­tion of the ­lesion sig­nif­i­cant­ly ­altered ­life expec­tan­cy com­pared to the ­mean lev­el for the ­over-80-­year-old pop­u­la­tion (5 ­years). Out of a ­total of 1298 ­patients under­go­ing endo­aneu­rys­mec­to­my, 26% ­were >80 ­years old (71 ­patients), and of ­these, 56 ­patients (22%) ­were oper­at­ed elec­tive­ly and 15 (4%) under­went emer­gen­cy sur­gery.
Results. The ­data ­obtained ­from ­this ­study con­firm the ­fact ­that, at a dis­tance of 54 ­months ­after tra­di­tion­al endo­aneu­rys­mat­ic sur­gery, ­over 82% of ­ultra-octo­ge­nar­ian ­patients had ­died. Death was asso­ciat­ed ­either ­with ­fatal com­pli­ca­tions relat­ing to pre-exist­ing ­risk fac­tors or the evo­lu­tion of pathol­o­gies unre­lat­ed to aneu­rys­mat­ic dis­ease.
Conclusions. In con­clu­sion, ­this ­study ­argues in ­favour of rethink­ing the ten­den­cy to oper­ate on ­ultra-octo­ge­nar­ian ­patients: sur­gery ­should be ­reserved for ­more favour­able cas­es ­based on the clin­i­cal con­di­tion of ­patients or for con­tin­gent sit­u­a­tions ­that ­call for emer­gen­cy treat­ment.