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Is there an age limit for abdominal aortic aneurysm repair?

Sonesson, Björn LU ; Dias, Nuno LU and Resch, Tim LU (2018) In Journal of Cardiovascular Surgery 59(2). p.190-194
Abstract

INTRODUCTION: There is an increasing number of elderly in society and some of them may have an abdominal aortic aneurysm (AAA). The prevalence of AAA in octo-And nonagenarians indicates that this number could be substantial. The question is: is there an age limit for repair? This complex question incorporates ethical, political, economic and medical aspects. To answer part of this question a review of the outcome of elective and emergent AAA repair in those over 80 was done. EVIDENCE ACQUISITION: A literature research was done in the PubMed and Embase databases between 2007 and 2017 for either emergent and/or elective repair of AAA in individuals older than 80 years of age. EVIDENCE SYNTHESIS: Ten of 663 studies were found eligible for... (More)

INTRODUCTION: There is an increasing number of elderly in society and some of them may have an abdominal aortic aneurysm (AAA). The prevalence of AAA in octo-And nonagenarians indicates that this number could be substantial. The question is: is there an age limit for repair? This complex question incorporates ethical, political, economic and medical aspects. To answer part of this question a review of the outcome of elective and emergent AAA repair in those over 80 was done. EVIDENCE ACQUISITION: A literature research was done in the PubMed and Embase databases between 2007 and 2017 for either emergent and/or elective repair of AAA in individuals older than 80 years of age. EVIDENCE SYNTHESIS: Ten of 663 studies were found eligible for the review. Elective AAA repair in individuals more than 80 years shows a very varying outcome with 30-day mortality between 0% and 20.1% and 1-year mortality between 7% and 26%. Length of procedure, hospital stay, and number of major adverse events are also more in those over 80 years of age. In ruptured AAA 30-day mortality is between 29 and 59 % and 1 one year between 45% and 63%. CONCLUSIONS: No definitive answer whether to perform a repair of AAA in the elderly can be given. The decision has to be individualized and will also vary depending on ethical, political, economic factors and type of healthcare system the individual lives in.

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Please use this url to cite or link to this publication:
author
; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
80 and over, Abdominal aortic aneurysm, Aged, Endovascular procedures
in
Journal of Cardiovascular Surgery
volume
59
issue
2
pages
5 pages
publisher
Edizioni Minerva Medica
external identifiers
  • pmid:29327568
  • scopus:85044529958
ISSN
0021-9509
DOI
10.23736/S0021-9509.18.10344-2
language
English
LU publication?
no
id
6b5b78b0-38df-441b-b0c0-179f9d6c5170
date added to LUP
2018-04-10 12:00:21
date last changed
2020-10-20 02:49:36
@article{6b5b78b0-38df-441b-b0c0-179f9d6c5170,
  abstract     = {<p>INTRODUCTION: There is an increasing number of elderly in society and some of them may have an abdominal aortic aneurysm (AAA). The prevalence of AAA in octo-And nonagenarians indicates that this number could be substantial. The question is: is there an age limit for repair? This complex question incorporates ethical, political, economic and medical aspects. To answer part of this question a review of the outcome of elective and emergent AAA repair in those over 80 was done. EVIDENCE ACQUISITION: A literature research was done in the PubMed and Embase databases between 2007 and 2017 for either emergent and/or elective repair of AAA in individuals older than 80 years of age. EVIDENCE SYNTHESIS: Ten of 663 studies were found eligible for the review. Elective AAA repair in individuals more than 80 years shows a very varying outcome with 30-day mortality between 0% and 20.1% and 1-year mortality between 7% and 26%. Length of procedure, hospital stay, and number of major adverse events are also more in those over 80 years of age. In ruptured AAA 30-day mortality is between 29 and 59 % and 1 one year between 45% and 63%. CONCLUSIONS: No definitive answer whether to perform a repair of AAA in the elderly can be given. The decision has to be individualized and will also vary depending on ethical, political, economic factors and type of healthcare system the individual lives in.</p>},
  author       = {Sonesson, Björn and Dias, Nuno and Resch, Tim},
  issn         = {0021-9509},
  language     = {eng},
  month        = {04},
  number       = {2},
  pages        = {190--194},
  publisher    = {Edizioni Minerva Medica},
  series       = {Journal of Cardiovascular Surgery},
  title        = {Is there an age limit for abdominal aortic aneurysm repair?},
  url          = {http://dx.doi.org/10.23736/S0021-9509.18.10344-2},
  doi          = {10.23736/S0021-9509.18.10344-2},
  volume       = {59},
  year         = {2018},
}