Kim Juan, Chung Sung Woon, Kim Jongwon, Bae Miju, Lee Chung Won, Huh Up
Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Yangsan, Korea.
J Chest Surg. 2025 Sep 5;58(5):196-204. doi: 10.5090/jcs.25.003. Epub 2025 Aug 7.
With an aging population, the number of patients over 80 undergoing abdominal aortic aneurysm (AAA) repair is increasing. This study examines factors associated with mortality in these patients.
A retrospective cohort study involving 66 patients aged >80 who underwent AAA repair between January 2010 and December 2022 was conducted. Baseline characteristics, treatment methods (open surgical repair [OSR] or endovascular aneurysm repair [EVAR]), post-treatment mortality, complications, and reinterventions were analyzed.
The mean age of patients was 82.74±2.64 years, with men comprising 74.2%. The OSR group had significantly younger patients than the EVAR group (81.92 years vs. 83.28 years, p=0.04). Rupture prevalence was significantly higher in the OSR group (27% vs. 7.5%, p=0.03). No significant difference was found in 30-day mortality rates between the OSR and EVAR groups (11.5% vs. 10%, p=0.85). Univariate logistic regression identified emergency surgery (odds ratio [OR], 6.18; p=0.04), post-treatment pneumonia (OR, 7.47; 95% confidence interval [CI], 1.00-55.70; p=0.05), and vasopressor use (OR, 44.57; p<0.01) as significant factors associated with 30-day mortality. Cox proportional hazard regression revealed age (hazard ratio [HR], 1.19; p=0.02), preoperative bedridden state (HR, 22.24; p<0.01), sacrifice of both internal iliac arteries (HR, 5.26; p=0.04), and postoperative vasopressor use (HR, 30.04; p<0.01) as significant predictors of overall mortality.
In patients aged >80 years, aneurysm rupture and emergency operation significantly increased 30-day mortality following AAA repair. Preoperative bedridden status, management of internal iliac arteries, and postoperative vasopressor use were significant predictors of overall mortality. When determining surgical indications and predicting outcomes, careful attention should be given to factors influencing mortality throughout the entire surgical process.
随着人口老龄化，80岁以上接受腹主动脉瘤（AAA）修复术的患者数量不断增加。本研究探讨了这些患者死亡的相关因素。
进行了一项回顾性队列研究，纳入了2010年1月至2022年12月期间66例年龄>80岁且接受AAA修复术的患者。分析了基线特征、治疗方法（开放手术修复[OSR]或血管腔内动脉瘤修复[EVAR]）、治疗后死亡率、并发症和再次干预情况。
患者的平均年龄为82.74±2.64岁，男性占74.2%。OSR组患者的年龄显著低于EVAR组（81.92岁对83.28岁，p=0.04）。OSR组的破裂发生率显著更高（27%对7.5%，p=0.03）。OSR组和EVAR组的30天死亡率无显著差异（11.5%对10%，p=0.85）。单因素逻辑回归确定急诊手术（比值比[OR]，6.18；p=
