title: Elective surgery for ascending aortic aneurysm in the elderly: should there be an age cut-off?
abstract: OBJECTIVE
  The objective of this study is to retrospectively analyse surgical outcomes in patients aged 75-79, and 80 and above.
  
  
  METHODS
  Between 2000 and 2015, 108 patients aged 75-79 (G 75 , mean age 76.9 ± 1.5years) and 72 patients aged 80 and above (G 80 , mean age 82.2 ± 2.1years) underwent elective aneurysm repair. Operative outcome and survival was compared with 727 contemporary younger counterparts aged <75 years (G Ctrl , mean age 56.6 ± 11.7years).
  
  
  RESULTS
  Postoperatively, patients with advanced age showed a higher incidence of prolonged ventilation (G 80 21.4%, G 75 8.4%, G Ctrl 2.9%; P < 0.001), low cardiac output syndrome (G 80 11.4%, G 75 1.9%, G Ctrl 2.2%; P = 0.001), multi organ failure (G 80 2.9%, G 75 0%, G Ctrl 0.1%; P = 0.022), haemofiltration (G 80 8.6%, G 75 0.9%, G Ctrl 0.6%; P < 0.001), and infection (G 80 10.0%, G 75 6.5%, G Ctrl 3.5%; P = 0.017). Operative mortality was significantly increased in the elderly (G 80 11.1%, G 75 3.7%, G Ctrl 1.4%; P < 0.001). Mid-term survival differed significantly between the surgical groups. Multivariate regression analysis precluded age as an independent predictor of operative mortality.
  
  
  CONCLUSIONS
  Elderly patients showed a higher operative risk compared to their younger counterparts. However, age per se is no suitable indicator of surgical risk and well-selected patients with large threatening aneurysms may benefit from intervention.
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.|Department of Cardiac Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Peterss
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Mansour
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Zafar
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Kabir
authors.initials: K
authors.lastname: Thombre
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.|Department of Economics and Department of Preventive Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Rizzo
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.|Department of Surgical Disease #2, Kazan State Medical University, Kazan, Russia.
authors.forename: Bulat A
authors.initials: BA
authors.lastname: Ziganshin
authors.affiliation: Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Umer M
authors.initials: UM
authors.lastname: Darr
authors.affiliation: Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Elefteriades
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000401:mortality*; D017558:Elective Surgical Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Advanced age; Aortic aneurysm; Aortic surgery; Octogenarians; Seniors; Septuagenarians 