Predictors of perioperative and late survival in octogenarians undergoing elective endovascular abdominal aortic repair

• Published in: Journal of vascular surgery 2019-05, Vol.69 (5), p.1405-1411
• Main Authors: Pini, Rodolfo, Gallitto, Enrico, Faggioli, Gianluca, Mascoli, Chiara, Vacirca, Andrea, Fenelli, Cecilia, Gargiulo, Mauro, Stella, Andrea
• Format: Article
• Language: English
• Subjects: EVAR; Octogenarian; Survival
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2018.07.059

The appropriateness of endovascular aneurysm repair (EVAR) of uncomplicated abdominal aortic aneurysm depends on the risk-benefit ratio, particularly in elderly patients with short life expectancy. The aim of this study was to assess the efficacy of EVAR in >80-year-old patients by evaluating their postoperative survival and analyzing the possible predictors of late mortality. All consecutive patients aged >80 years undergoing elective EVAR from 2006 to 2015 were prospectively evaluated. The 30-day mortality and long-term survival were assessed, and independent risk factors for mortality were determined by multivariate logistic and Cox analysis. Of a total of 1135 EVARs performed in a 10-year period, 201 (18%) occurred in patients older than 80 years. The median age was 84 years (interquartile range, 3 years), and 85% were male. Thirty-four patients (17%) had a score of 4 according to the American Society of Anesthesiologists (ASA) classification. Overall 30-day mortality was 2% (n = 4); it was significantly higher in those with ASA score of 4 compared with ASA score 80-year-old patients is associated with an overall early mortality rate as low as 2%. In patients with no or only one risk factor, the survival rate warrants the treatment of abdominal aortic aneurysm; in contrast, patients with ASA score of 4 and PAOD have a significantly higher mortality rate and reduction of life expectancy.