Elective surgery for ascending aortic aneurysm in the elderly: should there be an age cut-off?†

<span class="paragraphSection"><div class="boxTitle">Abstract</div><strong>OBJECTIVES:</strong> The objective of this study is to retrospectively analyse surgical outcomes in patients aged 75–79, and 80 and above.<strong>METHODS:</strong> Between 2000 and 2015, 108 patients aged 75–79 (G₇₅, mean age 76.9 ± 1.5years) and 72 patients aged 80 and above (G₈₀, mean age 82.2 ± 2.1years) underwent elective aneurysm repair. Operative outcome and survival was compared with 727 contemporary younger counterparts aged <75 years (G_Ctrl, mean age 56.6 ± 11.7years).<strong>RESULTS:</strong> Postoperatively, patients with advanced age showed a higher incidence of prolonged ventilation (G₈₀ 21.4%, G₇₅ 8.4%, G_Ctrl 2.9%; <span style="font-style:italic;">P</span> < 0.001), low cardiac output syndrome (G₈₀ 11.4%, G₇₅ 1.9%, G_Ctrl 2.2%; <span style="font-style:italic;">P</span> = 0.001), multi organ failure (G₈₀ 2.9%, G₇₅ 0%, G_Ctrl 0.1%; <span style="font-style:italic;">P</span> = 0.022), haemofiltration (G₈₀ 8.6%, G₇₅ 0.9%, G_Ctrl 0.6%; <span style="font-style:italic;">P</span> < 0.001), and infection (G₈₀ 10.0%, G₇₅ 6.5%, G_Ctrl 3.5%; <span style="font-style:italic;">P</span> = 0.017). Operative mortality was significantly increased in the elderly (G₈₀ 11.1%, G₇₅ 3.7%, G_Ctrl 1.4%; <span style="font-style:italic;">P</span> < 0.001). Mid-term survival differed significantly between the surgical groups. Multivariate regression analysis precluded age as an independent predictor of operative mortality. <strong>CONCLUSIONS:</strong> Elderly patients showed a higher operative risk compared to their younger counterparts. However, age <span style="font-style:italic;">per se</span> is no suitable indicator of surgical risk and well-selected patients with large threatening aneurysms may benefit from intervention.</span>

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