Document Detail


Elective surgery for thoracic aortic aneurysms: late functional status and quality of life.
MedLine Citation:
PMID:  16863767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elective surgical treatment for thoracic aortic aneurysms is unique in that it is often performed on asymptomatic patients. Although it has been found to improve survival, the impact of elective surgery on late functional status and quality of life have yet to be examined. METHODS: Over a 5-year period, 110 asymptomatic patients underwent elective thoracic aortic replacement for ascending, descending, or thoracoabdominal aneurysms. Mean age was 67 +/- 9 years (53 > or = 70 years). Functional status, physical and psychological quality of life (Medical Outcome Study 36-Item Short Form Health Survey, in which 50 represents normalized age-matched US population), and survival (Kaplan-Meier) were assessed. RESULTS: Return to normal activity level was independent of age (p > 0.59) and procedure (p > 0.18). At 35 +/- 20 months, psychological quality of life was similar between surgical groups (p > 0.71), but physical quality of life was lower after thoracoabdominal versus ascending or descending aneurysms (p < 0.02). Age did not impact physical quality of life (40 +/- 13 > or = 70 years versus 42 +/- 11 < 70 years, p > 0.58), but older patients had improved psychological quality of life (52 +/- 9 > or = 70 years versus 47 +/- 8 < 70 years, p > 0.03). Overall survival was 79% +/- 4% at 2 years and 70% +/- 5% at 4 years, but was lower with thoracoabdominal versus ascending or descending aneurysms (p < 0.002). Multivariate analysis identified thoracoabdominal (p < 0.004), advanced age (p < 0.03), chronic renal failure (p < 0.03), and congestive heart failure (p < 0.001) as predictors of late death. CONCLUSIONS: Advanced age did not impair return to normal functional status, and older patients had improved psychological quality of life. Survival and physical quality of life were lowest with thoracoabdominal versus ascending or descending aneurysms. Thus, patients with asymptomatic thoracic aneurysms should not be denied elective replacement based on age alone, as functional recovery was not significantly impaired.
Authors:
Andreas Zierer; Spencer J Melby; Jordon G Lubahn; Gregorio A Sicard; Ralph J Damiano; Marc R Moon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  82     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-25     Completed Date:  2006-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  573-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110-1013, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Aneurysm, Thoracic / mortality,  psychology,  surgery*
Female
Humans
Male
Middle Aged
Multivariate Analysis
Quality of Life*
Retrospective Studies
Surgical Procedures, Elective

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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