Aj. Berry et al., Age versus comorbidities as risk factors for complications after elective abdominal aortic reconstructive surgery, J VASC SURG, 33(2), 2001, pp. 345-352
Citations number
27
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Purpose: This study estimated the association between age and in-hospital p
ostoperative complications, controlling for known or suspected risk factors
, in a series of patients undergoing elective abdominal aortic reconstructi
ve surgery (AAR).
Methods: This retrospective cohort study of outcome data with multivariate
logistic regression analysis was conducted at Emery University Hospital, a
tertiary care, university-affiliated hospital. All patients undergoing elec
tive AAR between Jan 1, 1986, and Aug 1, 1996, were included (n = 856). An
estimate of the odds ratio (OR) and 95% CI for the association between pati
ent age and in-hospital major morbidity or mortality after elective AAR was
made, controlling for significant risk factors.
Results: Among the 856 patients, 170 had a nonfatal complication (136 with
major and 34 with minor complications), and II patients (1.3%) died. The fi
nal logistic regression model demonstrated a mild association between incre
asing age and rate of major postoperative complications, including death (f
or each increase in age of 10 years: OR, 1.23; 95% CI, 1.00-1.52; P = .052)
. Other significant covariates in the final model included cardiac disease
(OR, 2.84; 95% CI, 1.18-6.86; P = .020), pulmonary disease (OR, 1.96; 95% C
I, 1.35-2.84; P = .0004), and renal disease (OR, 2.57; 95% CI, 1.66-3.99; P
= .0001). Increasing age was associated with a moderate increase in the ra
te of death (for each increase in age of 10 years: OR, 2.74; 95% CI, 1.22-6
.16; P = .015) in a model with cardiac disease as the only significant cova
riate (OR, 14.67; 95% CI, 3.46-62.16; P = .0003).
Conclusion: For patients undergoing elective AAR, increasing patient age is
associated with a small increase in risk for in-hospital morbidity or mort
ality. However, significant cardiac, pulmonary, or renal disease is associa
ted with a much greater risk of postoperative complications, and, therefore
, advanced age should not be the sole basis of exclusion for otherwise suit
able candidates for elective AAR.