title: Quality of life and survival of septuagenarians and octogenarians after repair of descending and thoracoabdominal aortic aneurysms.
abstract: OBJECTIVE
  We assessed quality of life and survival in elderly patients after complex aortic operations to aid in surgical decision making.
  
  
  METHODS
  A retrospective review was performed of 93 patients who underwent descending thoracic aneurysm or thoracoabdominal aortic aneurysm (TAAA) repair from 2002 to 2008. A Cox model was used for survival analysis. The SF-36 Item Health Survey was administered to assess postoperative quality of life in 39 patients and was compared with age- and gender-matched normal scores.
  
  
  RESULTS
  The mean age at operation was 75 ± 4.1 years; 51% of patients were male. In-hospital mortality was 15%. One-year survival was 69%, and 5-year survival was 45%. Only acute respiratory distress syndrome was a predictor of in-hospital mortality (hazard ratio = 3.75; P < .01) and 1-year mortality (hazard ratio = 4.61; P < .001). After 1 year, patients enjoyed longevity equivalent to that of a normal age- and gender-matched population (standardized mortality ratio = 1.06; P = .81). Being male is a predictor of long-term survival (hazard ratio = 0.18; P < .05). For women, extremely low and high body mass indexes (quadratic term = 0.020; P < .05) with an inflection point of body mass index of 28 is a risk factor of long-term survival. Quality of life scores were similar to those of the general population except for lower vitality scores, (s-score = -0.67, 95% CI, -1.09 to -0.26).
  
  
  CONCLUSIONS
  TAAA repair in this selected older surgical population yields acceptable survival beyond the first year. Among 1-year survivors, quality of life is similar to that of an age- and gender-matched population.
authors.affiliation: Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, NY, USA. gabriele.diluozzo@mountsinai.org
authors.forename: Gabriele
authors.initials: G
authors.lastname: Di Luozzo
authors.forename: Aditya S
authors.initials: AS
authors.lastname: Shirali
authors.forename: Robin
authors.initials: R
authors.lastname: Varghese
authors.forename: Hung-Mo
authors.initials: HM
authors.lastname: Lin
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Weiss
authors.forename: Moritz S
authors.initials: MS
authors.lastname: Bischoff
authors.forename: Randall B
authors.initials: RB
authors.lastname: Griepp
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality