Age versus comorbidities as risk factors for complications after elective abdominal aortic reconstructive surgery

Arnold J. Berry, Robert B. Smith, William S. Weintraub, Elliot L. Chaikof, Thomas F. Dodson, Alan B. Lumsden, Atef A. Salam, Victor Weiss, Stephen Konigsberg

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Purpose: This study estimated the association between age and in-hospital postoperative complications, controlling for known or suspected risk factors, in a series of patients undergoing elective abdominal aortic reconstructive surgery (AAR). Methods: This retrospective cohort study of outcome data with multivariate logistic regression analysis was conducted at Emory University Hospital, a tertiary care, university-affiliated hospital. All patients undergoing elective AAR between Jan 1, 1986, and Aug 1, 1996, were included (n = 856). An estimate of the odds ratio (OR) and 95% CI for the association between patient age and in-hospital major morbidity or mortality after elective AAR was made, controlling for significant risk factors. Results: Among the 856 patients, 170 had a nonfatal complication (136 with major and 34 with minor complications), and 11 patients (1.3%) died. The final logistic regression model demonstrated a mild association between increasing age and rate of major postoperative complications, including death (for each increase in age of 10 years: OR, 1.23; 95% CI, 1.00-1.52; P = .052). Other significant covariates in the final model included cardiac disease (OR, 2.84; 95% CI, 1.18-6.86; P = .020), pulmonary disease (OR, 1.96; 95% CI, 1.35-2.84; P = .0004), and renal disease (OR, 2.57; 95% CI, 1.66-3.99; P = .0001). Increasing age was associated with a moderate increase in the rate of death (for each increase in age of 10 years: OR, 2.74; 95% CI, 1.22-6.16; P = .015) in a model with cardiac disease as the only significant covariate (OR, 14.67; 95% CI, 3.46-62.16; P = .0003). Conclusion: For patients undergoing elective AAR, increasing patient age is associated with a small increase in risk for in-hospital morbidity or mortality. However, significant cardiac, pulmonary, or renal disease is associated with a much greater risk of postoperative complications, and, therefore, advanced age should not be the sole basis of exclusion for otherwise suitable candidates for elective AAR.

Original languageEnglish (US)
Pages (from-to)345-352
Number of pages8
JournalJournal of Vascular Surgery
Volume33
Issue number2
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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