Operative results and death predictors for nonruptured abdominal aortic aneurysms in the elderly

Elective repair of abdominal aortic aneurysms (AAA) in the elderly has conv entionally been associated with higher mortality rates than in younger pati ents. although some authors do not agree with this view. The aim of this st udy is to look into current results of surgical treatment in elderly patien ts with nonruptured AAA and to define those factors associated with an incr eased mortality. Over a period of 2 years (1995-1996), 183 patients aged 75 or older were operated on for nonruptured AAA in 21 hospitals. Their medic al records were reviewed and those factors that could be related to death w ere analyzed. Those variables with statistical significance through univari ate analysis were entered into a multivariate logistic regression model to predict mortality. The results showed that surgery for nonruptured AAA in t he elderly has a greater mortality rate than that in younger patients, but it is not so great as to deny surgical correction to prevent rupture in sel ected cases, especially if they are unsuitable for endovascular repair. The se patients must first undergo thorough cardiac and renal function evaluati on. Selective screening must be considered, so earlier detection and treatm ent in younger patients can be performed.