Survival after surgery for acute type A aortic dissection in octogenarians

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43927828" target="_blank" >RIV/00064173:_____/24:43927828 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11120/24:43927828

Výsledek na webu

<a href="https://doi.org/10.26599/1671-5411.2024.11.009" target="_blank" >https://doi.org/10.26599/1671-5411.2024.11.009</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.26599/1671-5411.2024.11.009" target="_blank" >10.26599/1671-5411.2024.11.009</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Survival after surgery for acute type A aortic dissection in octogenarians

Popis výsledku v původním jazyce

OBJECTIVE: To evaluate the benefits of surgical repair acute type A aortic dissection (ATAAD) on survival of octogenarians. METHODS: Patients who underwent surgery for acute ATAAD from the multicenter European Registry of Type A Aortic Dissection (ERTAAD) were the subjects of the present analysis. RESULTS: 326 (8.4%) patients were aged &gt;= 80 years. Among 280 propensity score matched pairs, in-hospital mortality was 30.0% in patients aged &gt;= 80 years and 20.0% in younger patients (P = 0.006), while 10-year mortality were 93.2% and 48.0%, respectively (P &lt; 0.001). The hazard of mortality was higher among octogenarians up to two years after surgery, but it became comparable to that of younger patients up to 5 years. Among patients who survived 3 months after surgery, 10-year relative survival was 0.77 in patients aged &lt; 80 years, and 0.46 in patients aged &gt;= 80 years. Relative survival of octogenarians decreased markedly 5 years after surgery. Age &gt;= 85 years, glomerular filtration rate, preoperative invasive ventilation, preoperative mesenteric mal-perfusion and aortic root replacement were independent predictors of in-hospital mortality among octogenarians (AUC = 0.792; E:O ratio = 0.991; CITL = 0.016; slope = 1.096). An additive score was developed. A risk score &lt;= 1 was observed in 68.4% of patients, and their in-hospital mortality was 20.9%. CONCLUSIONS: Provided a thoughtful patient selection, surgery may provide a survival benefit in patients aged &gt;= 80 years with ATAAD that, when compared to younger patients and the general population, may last up to 5 years after the procedure. These findings have significant epidemiologic and clinical relevance because of the increasing longevity of the population of the Western countries.

Název v anglickém jazyce

Survival after surgery for acute type A aortic dissection in octogenarians

Popis výsledku anglicky

OBJECTIVE: To evaluate the benefits of surgical repair acute type A aortic dissection (ATAAD) on survival of octogenarians. METHODS: Patients who underwent surgery for acute ATAAD from the multicenter European Registry of Type A Aortic Dissection (ERTAAD) were the subjects of the present analysis. RESULTS: 326 (8.4%) patients were aged &gt;= 80 years. Among 280 propensity score matched pairs, in-hospital mortality was 30.0% in patients aged &gt;= 80 years and 20.0% in younger patients (P = 0.006), while 10-year mortality were 93.2% and 48.0%, respectively (P &lt; 0.001). The hazard of mortality was higher among octogenarians up to two years after surgery, but it became comparable to that of younger patients up to 5 years. Among patients who survived 3 months after surgery, 10-year relative survival was 0.77 in patients aged &lt; 80 years, and 0.46 in patients aged &gt;= 80 years. Relative survival of octogenarians decreased markedly 5 years after surgery. Age &gt;= 85 years, glomerular filtration rate, preoperative invasive ventilation, preoperative mesenteric mal-perfusion and aortic root replacement were independent predictors of in-hospital mortality among octogenarians (AUC = 0.792; E:O ratio = 0.991; CITL = 0.016; slope = 1.096). An additive score was developed. A risk score &lt;= 1 was observed in 68.4% of patients, and their in-hospital mortality was 20.9%. CONCLUSIONS: Provided a thoughtful patient selection, surgery may provide a survival benefit in patients aged &gt;= 80 years with ATAAD that, when compared to younger patients and the general population, may last up to 5 years after the procedure. These findings have significant epidemiologic and clinical relevance because of the increasing longevity of the population of the Western countries.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Geriatric Cardiology

ISSN

1671-5411

e-ISSN

—

Svazek periodika

21

Číslo periodika v rámci svazku

11

Stát vydavatele periodika

CN - Čínská lidová republika

Počet stran výsledku

11

Strana od-do

1015-1025

Kód UT WoS článku

001384887100002

EID výsledku v databázi Scopus

2-s2.0-85211992002