title: Outcome and survival of patients aged 65 years and younger after abdominal aortic aneurysm rupture.
abstract: Advanced age (> 80 years) confers a survival disadvantage after operative repair of a ruptured abdominal aortic aneurysm (AAA). This study aimed to determine if young age (< or =65 years) confers a survival benefit. Consecutive patients undergoing attempted repair of a ruptured AAA between 1995 and 2001 were included in the study. Demographic, clinical, and operative factors were analyzed together with in-hospital mortality, duration of postoperative hospital stay, and long-term survival. Of 378 patients admitted with a ruptured AAA, 52 (14%) were < or = 65 years of age and 326 (86%) were > 65 years. There were 4 (8%) women in the younger cohort compared to 74 (23%) women in the older group (p = 0.015). Four (8%) patients in the younger group were thought to be unsuitable for surgical repair compared to 77 (24%) patients in the older cohort (p = 0.009). Of the 48 younger patients who underwent attempted operative repair, 22 (46%) died in hospital, compared to 108 (43%) of 249 patients > 65 years (p = 0.753). The median (range) postoperative hospital stay of survivors was 11 days (6-59 days) in the younger cohort and 15 days (6-121 days) in the older group (p = 0.005). Patients < or = 65 years of age undergoing operative repair of ruptured AAA have no survival advantage over older patients. These data support AAA screening for the "at risk" and age-defined population.
authors.affiliation: Edinburgh Vascular Surgical Service, Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland, UK. andrew.tambyraja@ed.ac.uk
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Tambyraja
authors.forename: John A
authors.initials: JA
authors.lastname: Murie
authors.forename: Roderick T A
authors.initials: RT
authors.lastname: Chalmers
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome