Document Detail


Outcome after open repair of ruptured abdominal aortic aneurysm in patients>80 years old: a systematic review and meta-analysis.
MedLine Citation:
PMID:  21523501     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The role of open repair in the management of ruptured abdominal aortic aneurysm (RAAA) in patients>80 years old is questioned by the perceived high operative risk of these patients. This issue has been investigated in the present meta-analysis of observational studies.
METHODS: Studies on open repair of RAAA in patients>80 years old were identified in July 2010. The immediate and intermediate results were expressed as pooled proportions with 95% confidence interval (95% CI). Linear regression and meta-regression were performed to evaluate the impact of variables on the immediate postoperative mortality.
RESULTS: Pooled analysis of 29 studies showed that the risk of immediate postoperative mortality in patients>80 years old was significantly higher than in younger patients (risk ratio 1.440, 95%CI 1.365-1.519, I2 36.8%, P=0.002; risk difference 19.4%, 95% CI 16.4-22.4%, I2 38.8%, P=0.019). Pooled analysis of 36 studies showed an immediate postoperative mortality rate of 59.2% (95% CI 55.7-62.5, I2 35.62). Immediate postoperative mortality in patients<80 years old positively correlated with that of patients>80 years old (rho: 0.686, P<0.0001). Intermediate survival data of 111 operative survivors were available from six studies, and their pooled survival rates at 1-, 2-, and 3-year were 82.4, 75.6, and 68.7%, respectively.
CONCLUSIONS: Immediate and intermediate survival rates of patients>80 years old after open repair of RAAA are acceptable. These findings suggest a more confident approach toward emergency repair of RAAA in the very elderly.
Authors:
Fausto Biancari; Maria Alessandra Mazziotti; Rosalba Paone; Sani Laukontaus; Maarit Venermo; Mauri Lepäntalo
Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  World journal of surgery     Volume:  35     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-22     Completed Date:  2011-10-27     Revised Date:  2011-11-14    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1662-70     Citation Subset:  IM    
Affiliation:
Division of Cardio-thoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029, Oulu, Finland. faustobiancari@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Aortic Aneurysm, Abdominal / surgery*
Aortic Rupture / surgery*
Humans
Treatment Outcome
Comments/Corrections
Comment In:
World J Surg. 2011 Nov;35(11):2575-6; author reply 2577   [PMID:  21845458 ]

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


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