Mortality after elective abdominal aortic aneurysm repair.
OBJECTIVE
Purpose of this study is to provide detailed age- and gender-specific mortality risks of patients hospitalized for elective AAA repair.


BACKGROUND
Whether to perform elective abdominal aortic aneurysm (AAA) surgery is balancing the risks of natural history against the risks of surgical intervention. Literature is lacking mortality risks after elective AAA repair with stratification by both age and gender.


METHODS
Mortality risks for 28 days, 1 year, and 5 years were derived from a nationwide cohort of patients hospitalized for elective AAA repair in 1997 or 2000. This cohort was formed through linkage of the Hospital Discharge Register with the Dutch Population Register. The relations between demographics, medical history and mortality were studied by Cox regression.


RESULTS
A total of 3457 patients were identified; 86% males, mean age 72 +/- 8.0 years. Mortality risks after elective AAA repair increased with age: 28-day mortality ranged from 3.3% to 27.1% in men and 3.8% to 54.3% in women, 5-year mortality from 12.9% to 78.1% in men and 24.3% to 91.3% in women. Higher age, congestive heart failure, cerebrovascular disease and diabetes mellitus were independent risk factors for 5-years mortality.


CONCLUSIONS
Mortality risks after elective AAA repair are strongly age-related. Age, gender, and comorbidities should be taken into account when deciding on surgery. A general threshold of 55 mm for surgery might not be justified for all patients.
Department of Surgery, Section of Vascular Surgery, Yale University School of Medicine, New Haven, CT, USA.
Felix J V
FJ
Schlösser
Ilonca
I
Vaartjes
Geert J M G
GJ
van der Heijden
Frans L
FL
Moll
Hence J M
HJ
Verhagen
Bart E
BE
Muhs
Gert J
GJ
de Borst
Andreas T
AT
Tiel Groenestege
Jan W P F
JW
Kardaun
Agnes
A
de Bruin
D000367:Age Factors; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D002423:Cause of Death; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate