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Hospital mortality of patients aged 80 and older after surgical repair for type A acute aortic dissection in Japan.

Ohnuma T, Shinjo D, Fushimi K - Medicine (Baltimore) (2016)

Bottom Line: The mean age of patients was 67.1 ± 13.0 years, and the male:female ratio was 51:49.Patients aged 80 and older more frequently received tracheostomy than their younger counterparts (9.5% vs 5.4%, P <0.001).Intensive care unit and hospital stays were significantly longer in the elderly cohort versus the younger cohort (7.6 vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.

ABSTRACT
To evaluate whether patients aged 80 and older have higher risk of hospital mortality after repair of type A acute aortic dissection (TAAAD).Emergency surgery for TAAAD in patients aged 80 and older remains a controversial issue because of its high surgical risk.Data from patients who underwent surgical repair of TAAAD between April 2011 and March 2013 were retrospectively extracted from the Japanese Diagnosis Procedure Combination database. The effect of age on hospital mortality was evaluated using multivariate logistic regression analysis.A total of 5175 patients were enrolled. The mean age of patients was 67.1 ± 13.0 years, and the male:female ratio was 51:49. Patients aged 80 and older more frequently received tracheostomy than their younger counterparts (9.5% vs 5.4%, P <0.001). Intensive care unit and hospital stays were significantly longer in the elderly cohort versus the younger cohort (7.6 vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively). Logistic regression analysis showed that age ≥80 years was significantly associated with a higher risk of hospital mortality (adjusted odds ratio, 1.62; 95% confidence interval, 1.28-2.06; P <0.001). In linear regression analysis, age ≥80 years was also significantly associated with longer hospital stay (P = 0.007).In a large, nationwide, Japanese database, patients aged 80 and older were at increased risk of hospital mortality and length of hospital stay.

No MeSH data available.


Related in: MedlinePlus

Hospital mortality categorized by age group (10-year increments). The number of patients in each group is shown below the x-axis.
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Figure 2: Hospital mortality categorized by age group (10-year increments). The number of patients in each group is shown below the x-axis.

Mentions: Table 2 shows postoperative complications and outcomes. Approximately 6.3% of patients in each group underwent reoperation. Patients aged 80 and older more frequently received tracheostomy than did those younger than 80 years (9.5% vs 5.4%, P <0.001). Mean ventilation days (7.6 ± 16.3 days), renal replacement therapy (6.1%), and consciousness level at discharge did not differ between 2 groups. ICU and hospital stays were significantly longer in the older cohort (7.6 days vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively). Figure 2 shows that when patients were stratified by age, those older than 90 years had the highest mortality (20.6%).


Hospital mortality of patients aged 80 and older after surgical repair for type A acute aortic dissection in Japan.

Ohnuma T, Shinjo D, Fushimi K - Medicine (Baltimore) (2016)

Hospital mortality categorized by age group (10-year increments). The number of patients in each group is shown below the x-axis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979811&req=5

Figure 2: Hospital mortality categorized by age group (10-year increments). The number of patients in each group is shown below the x-axis.
Mentions: Table 2 shows postoperative complications and outcomes. Approximately 6.3% of patients in each group underwent reoperation. Patients aged 80 and older more frequently received tracheostomy than did those younger than 80 years (9.5% vs 5.4%, P <0.001). Mean ventilation days (7.6 ± 16.3 days), renal replacement therapy (6.1%), and consciousness level at discharge did not differ between 2 groups. ICU and hospital stays were significantly longer in the older cohort (7.6 days vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively). Figure 2 shows that when patients were stratified by age, those older than 90 years had the highest mortality (20.6%).

Bottom Line: The mean age of patients was 67.1 ± 13.0 years, and the male:female ratio was 51:49.Patients aged 80 and older more frequently received tracheostomy than their younger counterparts (9.5% vs 5.4%, P <0.001).Intensive care unit and hospital stays were significantly longer in the elderly cohort versus the younger cohort (7.6 vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.

ABSTRACT
To evaluate whether patients aged 80 and older have higher risk of hospital mortality after repair of type A acute aortic dissection (TAAAD).Emergency surgery for TAAAD in patients aged 80 and older remains a controversial issue because of its high surgical risk.Data from patients who underwent surgical repair of TAAAD between April 2011 and March 2013 were retrospectively extracted from the Japanese Diagnosis Procedure Combination database. The effect of age on hospital mortality was evaluated using multivariate logistic regression analysis.A total of 5175 patients were enrolled. The mean age of patients was 67.1 ± 13.0 years, and the male:female ratio was 51:49. Patients aged 80 and older more frequently received tracheostomy than their younger counterparts (9.5% vs 5.4%, P <0.001). Intensive care unit and hospital stays were significantly longer in the elderly cohort versus the younger cohort (7.6 vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively). Logistic regression analysis showed that age ≥80 years was significantly associated with a higher risk of hospital mortality (adjusted odds ratio, 1.62; 95% confidence interval, 1.28-2.06; P <0.001). In linear regression analysis, age ≥80 years was also significantly associated with longer hospital stay (P = 0.007).In a large, nationwide, Japanese database, patients aged 80 and older were at increased risk of hospital mortality and length of hospital stay.

No MeSH data available.


Related in: MedlinePlus