Abdominal aortic aneurysms in aged patients: analysis of risk factors in non-ruptured cases

Background and methods. A retrospective analysis of 304 patients (274 males and 30 females) surgically treated for non-ruptured, infrarenal abdominal aortic aneurysm (AAA) to determine the relative contribution of preoperativ e, operative, and postoperative factors to mortality and to the development of postoperative complications. 1) Risk factors, hospital mortality and lo ng-term survival rate were compared between patients aged 75 or older (grou p I; n=79) and those under 75 years of age (group II; n=225), 2) These risk factors were subjected to univariate and multivariate analysis to determin e their relative contribution to patient hospital mortality and to the deve lopment of major postoperative complications in aged patients, Results. Maximum diameter of AAA, the prevalence of respiratory dysfunction , diabetes mellitus and the total volumes of intraoperative blood loss were significantly different between the two groups, A higher hospital mortalit y was noted in the aged patients (10.1% versus 3.1%, p<0.05). The majority of deaths in group I resulted from organ dysfunctions, especially involved with respiratory failure. The long term survival rate at 3 and 5 years was not different between operative survivors in the two groups, Incremental ri sk factors for hospital death in aged patients included the presence of sym ptomatic AAA, the maximum diameter of AAA, the postoperative development of myocardial infarction, respiratory complications and gastrointestinal blee ding, Operation time and the volumes of intraoperative blood loss significa ntly correlated with the postoperative development of respiratory failure, renal failure and multiple organ failure. Conclusions. 1) A higher operative mortality and higher prevalence of posto perative complications were noted in aged patients with AAA. 2) To reduce o peration time and the volumes of intraoperative blood loss would be essenti al to improve surgical results of AAA in aged patients.