دورية أكاديمية
أعرض في EDS

Operative treatment of abdominal aortic aneurysms in octogenarians. When is it too much too late?

التفاصيل البيبلوغرافية
العنوان: Operative treatment of abdominal aortic aneurysms in octogenarians. When is it too much too late?
المؤلفون: Dean RH; Department of Surgery and Public Health Sciences, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina., Woody JD, Enarson CE, Hansen KJ, Plonk GW Jr
المصدر: Annals of surgery [Ann Surg] 1993 Jun; Vol. 217 (6), pp. 721-8.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print Cited Medium: Print ISSN: 0003-4932 (Print) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Aortic Aneurysm, Abdominal/*surgery , Aortic Rupture/*surgery, Age Factors ; Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/economics ; Aortic Aneurysm, Abdominal/pathology ; Aortic Rupture/economics ; Aortic Rupture/pathology ; Blood Vessel Prosthesis ; Cause of Death ; Costs and Cost Analysis ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Male ; Postoperative Complications ; Survival Rate ; Treatment Outcome
مستخلص: Objective: This study evaluated the value of operation for treatment of all octogenarians with ruptured abdominal aortic aneurysms (AAA).
Summary Background Data: Elective AAA resection in octogenarians is safe, with published operative mortality rates of approximately 5%. Published operative mortality rates of ruptured AAA in this age group, however, vary from 27 to 92%.
Methods: To evaluate this question, we extracted the clinical course of the 34 octogenarians submitted to AAA resection by the authors from our total experience of 548 resections performed during the past 7 1/2 years. In this subgroup of octogenarians, 18 underwent elective AAA replacement, 5 were submitted to urgent resection of active but intact AAAs, and 11 had operations for ruptured AAAs. There were 23 males and 11 females in the group. The ages ranged from 80 to 91 years.
Results: Operative mortality in the patients managed electively was 5.6%. Two of the five patients (40%) submitted to operation for active yet unruptured aneurysms died in the preoperative period. Finally, 10 of the 11 patients (91%) with ruptured AAAs were operative mortalities. All of these operative mortalities in the ruptured AAA subgroup had severe hypotension preoperatively (mean systolic blood pressure: 23 mm Hg). The charges associated with the management of the ruptured AAA group averaged $84,486 (range $12,537-$199,233).
Conclusions: Although elective replacement of AAA in properly selected octogenarians appears valuable to prolong worthwhile life expectancy, this experience leads us to consider observation only in the treatment of octogenarians with ruptured AAA who present with severe hemodynamic instability.
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تواريخ الأحداث: Date Created: 19930601 Date Completed: 19930702 Latest Revision: 20190514
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC1242884
DOI: 10.1097/00000658-199306000-00014
PMID: 8507118
قاعدة البيانات: MEDLINE
الوصف
تدمد:0003-4932
DOI:10.1097/00000658-199306000-00014