title: Should ruptured abdominal aortic aneurysms be repaired in the octogenarian?
abstract: OBJECTIVE
  Several investigators have suggested a dismal prognosis of ruptured abdominal aortic aneurysm (rAAA) repair in the elderly. The purpose of this study is to evaluate the morbidity and mortality of rAAA repair in octogenarians and compare it to that of a younger population.
  
  
  METHODS
  From 1980 to 2000, all patients undergoing emergent rAAA repair were divided into two groups based on their age; Group I: age <80, Group II: > or =80 years. Outcomes were evaluated based on a Chi-square test and a P-value <0.05 indicated statistical significance.
  
  
  RESULTS
  Over a 20-year period, 323 patients underwent rAAA repair through a left retroperitoneal (74%) or standard transperitoneal (26%) approach. In Group I (age <80 years) and II (> or =80 years), the overall 30-day mortality was 25 and 41% (P<0.05), respectively. Furthermore, the elderly population had a higher incidence of death due to myocardial infarction (15 vs. 7%), as well as non-fatal cardiac and cerebrovascular events (17 vs. 4%) when compared to the younger patients.
  
  
  CONCLUSIONS
  Although the elderly patients have an increased risk of having cardiac and cerebrovascular events in the postoperative period, the treatment of rAAAs in these patients should not be any different than that of a younger population. The left retroperitoneal approach is feasible and beneficial for rAAA repair and is associated with a limited morbidity and mortality.
authors.affiliation: Albany Medical College, Institute for Vascular Health and Disease MC157, 47 New Scotland Avenue, Albany, NY 12208, USA.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Roddy
authors.forename: R Clement
authors.initials: RC
authors.lastname: Darling
authors.forename: Dale
authors.initials: D
authors.lastname: Maharaj
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Ozsvath
authors.forename: Manish
authors.initials: M
authors.lastname: Mehta
authors.forename: Philip S K
authors.initials: PS
authors.lastname: Paty
authors.forename: Paul B
authors.initials: PB
authors.lastname: Kreienberg
authors.forename: Daniel
authors.initials: D
authors.lastname: Choi
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Chang
authors.forename: Dhiraj M
authors.initials: DM
authors.lastname: Shah
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome