title: [Open surgery of infra-renal abdominal aortic aneurysm in octogenarians: Redefining the concept of high-risk patient].
abstract: OBJECTIVE
  Evaluation of the results of open surgery for infra-renal abdominal aortic aneurysm in octogenarians, characterizing the population, risk factors and fitness for surgery. Correlation of risk factors and morbidity/mortality.
  
  
  METHODS
  Review of all octogenarian patients submitted to elective surgery for infra-renal abdominal aortic aneurysm between January 2005 and July 2011, in this department. Patient demographics and risk factors were analyzed. Kaplan Meier survival estimates were performed to assess time-dependent prognosis of the surgical procedure. Fitness for surgery was assessed based on Customized Probability Index ( CPI ) and quality of life after discharge according to the SF-8 questionnaire from IQOLA™. Software: IBM®SPSS®19.
  
  
  RESULTS
  A total of 28 patients were treated during this period ( 82.1 % male, mean age 81.9 ± 2.3 years ). Mean follow-up was 29.3 ± 19.9 months. 17 patients presented with abdominal aortic aneurysm and 11 with aorto-iliac aneurysm. There were no cases of 30-day mortality and global morbidity was 21.4 %. Mortality was 3.6 % at 1 year, 17.9 % at 3 years and 21.4 % at 5 years. There was no aneurysm related mortality at 5 years. Average length of stay was 13.2 ± 10.3 days and 7.2 ± 7.5 days on ICU. 71.4 % of patients were considered ASA 3 and the average CPI was 6.2. Average quality of life 30 days post-operatory was 41.8 ( SF-8 ).
  
  
  CONCLUSIONS
  Elective open repair of infra-renal abdominal aortic aneurysm has excellent results in octogenarians, even when comparing with the results of the most relevant studies for EVAR. Age is not a contra-indication for surgery and fitness for surgery was acceptable in the vast majority of patients. Durability of the procedure should not be discarded in this group, as the majority of patients are alive 3 years after surgery.
authors.affiliation: Clinica Universitária de Cirurgia Vascular do Hospital de Santa Maria, Laboratório de Biomatemática da Faculdade de Medicina de Lisboa.
authors.forename: Gonçalo
authors.initials: G
authors.lastname: Cabral
authors.forename: José
authors.initials: J
authors.lastname: Tiago
authors.forename: Augusto
authors.initials: A
authors.lastname: Ministro
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodrigues
authors.forename: Madalena
authors.initials: M
authors.lastname: Romero
authors.forename: Carlos
authors.initials: C
authors.lastname: Martins
authors.forename: A
authors.initials: A
authors.lastname: Dinis da Gama
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000379:methods