World Journal of Surgery

, Volume 35, Issue 7, pp 1662–1670 | Cite as

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

  • Fausto Biancari
  • Maria Alessandra Mazziotti
  • Rosalba Paone
  • Sani Laukontaus
  • Maarit Venermo
  • Mauri Lepäntalo
Article
First Online:

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.

Keywords

Abdominal Aortic Aneurysm Postoperative Mortality Open Repair Endovascular Repair Late Survival 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Supplementary material

268_2011_1103_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 19 kb)

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Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Fausto Biancari
    • 1
  • Maria Alessandra Mazziotti
    • 1
  • Rosalba Paone
    • 1
  • Sani Laukontaus
    • 2
  • Maarit Venermo
    • 2
  • Mauri Lepäntalo
    • 2
  1. 1.Division of Cardio-thoracic and Vascular Surgery, Department of SurgeryOulu University HospitalOuluFinland
  2. 2.Department of Vascular SurgeryHelsinki University HospitalHelsinkiFinland

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