The early results of vascular surgery in patients 75 years of age and older: an analysis of 3259 cases.
The population in the United States older than 75 years of age will double by the year 2000. The computerized registry of The Cleveland Vascular Society includes 19,990 vascular procedures, which have been divided into two groups. Group A consists of 16,731 operations performed on patients younger than 75 years of age and group B consists of 3259 procedures performed on patients older than 75 years of age. The overall operative mortality rate in group A was 4.4% (736 of 16,731). In subsets of group B the mortality rates were: age 75 to 79 years, 11.3% (210 of 1862), age 80 to 84 years, 13.4% (125 of 932), age 85 to 89 years, 18.0% (68 of 376), and age 90 to 98 years, 28.1% (25 of 89). In carotid endarterectomy there were no significant differences in the stroke and operative mortality rates when groups A and B were compared. Group A stroke rate was 1.8% (94 of 5220), operative mortality rate was 1.5% (77 of 5220); group B stroke rate was 2.2% (17 of 782) and the mortality rate was 2.3% (18 of 782). For aortic reconstructions group A mortality rate was 7.1% (276 of 3905); group B operative mortality rate was 24.1% (148 of 615) (p less than 0.001). In femoropopliteal reconstructions group A operative mortality rate was 2.2% (55 of 2377) and group B mortality rate was 6.7% (38 of 571) (p less than 0.0001). For lower extremity thromboembolectomy group A operative mortality rate was 14.3% (113 of 789) and the mortality rate for group B was 28.4% (196 of 689) (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D000671:Amputation, Surgical; D001014:Aortic Aneurysm / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000601:surgery; D002339:Carotid Arteries / Q000601:surgery; D004691:Endarterectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007866:Leg / Q000098:blood supply; D013923:Thromboembolism / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality