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World Journal of Surgery

Published in:

01-07-2011

Outcome after Open Repair of Ruptured Abdominal Aortic Aneurysm in Patients >80 Years Old: A Systematic Review and Meta-analysis

Authors: Fausto Biancari, Maria Alessandra Mazziotti, Rosalba Paone, Sani Laukontaus, Maarit Venermo, Mauri Lepäntalo

Published in: World Journal of Surgery | Issue 7/2011

Abstract

Background

The role of open repair in the management of ruptured abdominal aortic aneurysm (RAAA) in patients >80 years old is questioned by the perceived high operative risk of these patients. This issue has been investigated in the present meta-analysis of observational studies.

Methods

Studies on open repair of RAAA in patients >80 years old were identified in July 2010. The immediate and intermediate results were expressed as pooled proportions with 95% confidence interval (95% CI). Linear regression and meta-regression were performed to evaluate the impact of variables on the immediate postoperative mortality.

Results

Pooled analysis of 29 studies showed that the risk of immediate postoperative mortality in patients >80 years old was significantly higher than in younger patients (risk ratio 1.440, 95%CI 1.365–1.519, I ² 36.8%, P = 0.002; risk difference 19.4%, 95% CI 16.4–22.4%, I ² 38.8%, P = 0.019). Pooled analysis of 36 studies showed an immediate postoperative mortality rate of 59.2% (95% CI 55.7–62.5, I ² 35.62). Immediate postoperative mortality in patients <80 years old positively correlated with that of patients >80 years old (rho: 0.686, P < 0.0001). Intermediate survival data of 111 operative survivors were available from six studies, and their pooled survival rates at 1-, 2-, and 3-year were 82.4, 75.6, and 68.7%, respectively.

Conclusions

Immediate and intermediate survival rates of patients >80 years old after open repair of RAAA are acceptable. These findings suggest a more confident approach toward emergency repair of RAAA in the very elderly.

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Title: Outcome after Open Repair of Ruptured Abdominal Aortic Aneurysm in Patients >80 Years Old: A Systematic Review and Meta-analysis
Authors: Fausto Biancari
Maria Alessandra Mazziotti
Rosalba Paone
Sani Laukontaus
Maarit Venermo
Mauri Lepäntalo
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 7/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1103-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome after Open Repair of Ruptured Abdominal Aortic Aneurysm in Patients >80 Years Old: A Systematic Review and Meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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