Analysis of Mortality-Related Factors in Patients Aged >80 Years Treated for Abdominal Aortic Aneurysms.

Abstract

Background: With an aging population, the number of patients over 80 undergoing abdominal aortic aneurysm (AAA) repair is increasing. This study examines factors associated with mortality in these patients.

Methods: A retrospective cohort study involving 66 patients aged >80 who underwent AAA repair between January 2010 and December 2022 was conducted. Baseline characteristics, treatment methods (open surgical repair [OSR] or endovascular aneurysm repair [EVAR]), post-treatment mortality, complications, and reinterventions were analyzed.

Results: The mean age of patients was 82.74±2.64 years, with men comprising 74.2%. The OSR group had significantly younger patients than the EVAR group (81.92 years vs. 83.28 years, p=0.04). Rupture prevalence was significantly higher in the OSR group (27% vs. 7.5%, p=0.03). No significant difference was found in 30-day mortality rates between the OSR and EVAR groups (11.5% vs. 10%, p=0.85). Univariate logistic regression identified emergency surgery (odds ratio [OR], 6.18; p=0.04), post-treatment pneumonia (OR, 7.47; 95% confidence interval [CI], 1.00-55.70; p=0.05), and vasopressor use (OR, 44.57; p<0.01) as significant factors associated with 30-day mortality. Cox proportional hazard regression revealed age (hazard ratio [HR], 1.19; p=0.02), preoperative bedridden state (HR, 22.24; p<0.01), sacrifice of both internal iliac arteries (HR, 5.26; p=0.04), and postoperative vasopressor use (HR, 30.04; p<0.01) as significant predictors of overall mortality.

Conclusion: In patients aged >80 years, aneurysm rupture and emergency operation significantly increased 30-day mortality following AAA repair. Preoperative bedridden status, management of internal iliac arteries, and postoperative vasopressor use were significant predictors of overall mortality. When determining surgical indications and predicting outcomes, careful attention should be given to factors influencing mortality throughout the entire surgical process.