Print this pageAge-Stratified, One Year Mortality Following Abdominal Aortic Aneurysm Repair: A Statewide Experience
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Abstract 03
David A. Rigberg, MD, David Zingmond, MD, Melinda Maggard, MD, Marcia McGory, MD, Michelle Agustin, MPH, Peter Lawrence, MD, Clifford Ko, MD.
UCLA, Los Angeles, CA, USA.
Introduction: Improvements in perioperative care and the expanded application of endovascular grafting have increased the candidate pool for AAA repair. Although 30 day mortality for this procedure has been characterized, the intermediate mortality has not been adequetely determined. This measurement may be of particular importance for a disease process effecting a predominantly geriatric patient group. The objective of this study was to determine the perioperative and non-perioperative one-year mortality for AAA repairs when stratified by age.
Methods: Using the California inpatient file linked to the state death files, we determined mortality rates for all patients with ICD-9 coding for elective and urgent repair of AAA from 1995-1999. These were stratified by age in decades. Test of proportion was used to determine statistical significance between 30 day mortality and those deaths occuring in the balance of the year by age groups.
Results: 11,526 patients were identified for the study.
Elective Repairs
| Age range | 51-60 | 61-70 | 71-80 | 81-90 | >91 |
| Number pts | 537 | 2,654 | 4,153 | 988 | 16 |
| Mortality day 0-30 | 2.79% | 3.35% | 4.84%** | 6.88%* | 18.75% |
| Mortality day 31-365 | 1.34% | 3.39% | 6.33%** | 9.57%* | 15.38% |
Urgent Repairs
| Age range | 51-60 | 61-70 | 71-80 | 81-90 | >91 |
| Number pts | 266 | 1046 | 1418 | 433 | 15 |
| Mortality day 0-30 | 16.88%** | 20.21%† | 29.35%† | 41.57%† | 72.73%* |
| Mortality day 31-365 | 6.77%** | 8.13%† | 14.88%† | 21.25%† | 20.00%* |
*p≤0.03, **p≤0.003, †p<0.0001
Conclusion: Our data demonstrate that for patients > 70 years of age, there is a statistically higher mortality rate from postoperative day 31-365 than in the 30 day perioperative period for elective AAA repair. There is even higher mortality in this time frame for patients undergoing urgent repair, although it is overshadowed by the number of deaths in the perioperative period. Mortality overall increases with age.