title: Early and Late Outcomes of Operation for Acute Type A Aortic Dissection in Patients Aged 80 Years and Older.
abstract: BACKGROUND
  The number of elderly patients undergoing emergency operation for acute type A aortic dissection is increasing in the aging society. We examined the early and late outcomes of operation for acute type A aortic dissection in elderly patients (≥80 years old).
  
  
  METHODS
  From January 2001 to December 2015, 345 consecutive patients underwent surgical treatment for acute type A aortic dissection at our institution. Of these, 63 elderly patients (≥80 years old; 28 men; mean age, 83.7 ± 3.0 years) were reviewed and compared with nonelderly patients (≤79 years old).
  
  
  RESULTS
  The hospital death was 9/63 (14.3%) and 25/282 (8.9%) in patients 80 years and older but 79 years or younger, respectively (p = 0.28). Multivariate analysis showed age 80 years or older was a significant risk factor for hospital mortality (odds ratio 3.27, 95% confidence interval: 1.22 to 8.76, p = 0.02). During follow-up period (mean, 51.3 ± 40.9 months; range, 1 to 162 months), the 5-year survival of the elderly patients discharged from the hospital was 58.6% ± 8.7%. At postoperative 6 months and the latest follow-up (mean, 44.3 ± 25.6 months) of the elderly patients excluding late death, 90.2% (46/51) and 88% (22/25) of elderly patients had totally or almost independent daily life, respectively.
  
  
  CONCLUSIONS
  Although age 80 years or older was the risk factor for hospital mortality in operation for acute type A aortic dissection, the long-term survival of the hospital survivors and the level of activity of daily life were acceptable. Aggressive surgical treatment could be a reasonable option for selected elderly patients.
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan. Electronic address: atchun1029@gmail.com.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Omura
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuda
authors.affiliation: Division of Cardiovascular Surgery, Ako Municipal Hospital, Hyogo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Minami
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nakai
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Henmi
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Mukohara
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*