| Outcome after open repair of ruptured abdominal aortic aneurysm in patients>80 years old: a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 21523501 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Fausto Biancari; Maria Alessandra Mazziotti; Rosalba Paone; Sani Laukontaus; Maarit Venermo; Mauri Lepäntalo |
Publication Detail:
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Type: Journal Article; Meta-Analysis; Review |
Journal Detail:
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Title: World journal of surgery Volume: 35 ISSN: 1432-2323 ISO Abbreviation: World J Surg Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-07-22 Completed Date: 2011-10-27 Revised Date: 2011-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1662-70 Citation Subset: IM |
Affiliation:
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Division of Cardio-thoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029, Oulu, Finland. faustobiancari@yahoo.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Aortic Aneurysm, Abdominal / surgery* Aortic Rupture / surgery* Humans Treatment Outcome |
| Comments/Corrections | |
Comment In:
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World J Surg. 2011 Nov;35(11):2575-6; author reply 2577
[PMID:
21845458
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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