Risk factors and operative results of patients aged less than 66 years operated on for asymptomatic abdominal aortic aneurysm.

OBJECTIVE

To report risk factors, early operative results and survival after repair of asymptomatic abdominal aortic aneurysm (AAA) in patients aged less than 66 years.

DESIGN

a retrospective study based on a prospectively updated database in a University hospital.

PATIENTS AND METHODS

Between 1985 and 1999, 118 patients of less than 66 years were operated for AAA. Pre-operative risk factors, early complications, operative mortality (<30 days), and survival are compared with that of 333 older patients operated during the same period.

RESULTS

Risk factors were similar to older patients. Serious early (<30 days) complications were recorded in 20% of both groups. The operative mortality was 1.7% for the younger patients and 6% for the older (n.s.). The eight-year survival of the younger patients was 69%, which was significantly below that of a demographically matched population. The older patients had a significantly poorer eight-year survival of 47% (p<0.01), but their relative survival was significantly better (p<0.05).

CONCLUSIONS

Younger patients with an AAA were not healthier than older patients. Complications were equally common among both groups. Although the operative mortality was lower, the long-term relative survival was poorer than that of the older patient. Present data do not support a more aggressive surgical attitude towards the younger patients with an asymptomatic abdominal aortic aneurysm, as compared to the older.