With the progressive aging of Western populations, cardiac surgeons are faced with treating an increasing number of elderly patients. Controversy exists as to whether the expenditure of health care resources on the growing elderly populations represents a cost-effective approach to resource management. The potential to avoid surgery in patients with little chance of survival and poor quality of life would spare unnecessary suffering, reduce operative mortality, and enhance the use of scarce resources. METHODS: We reviewed the records of 24 consecutive patients aged 80 years or older (mean age 83 years, range 80-93 years) who underwent operations for acute type A dissection from 1985 through 1999. No patient with acute type A dissection was refused surgery because of age or concomitant disease. Seventeen patients were men. Preoperatively, none of the patients was moribund, although 66% had hemodynamic instability and 41% experienced cerebral ischemia. All patients had one or more associated pathologic conditions. Hospital mortality and morbidity models, based on our overall experience with 197 patients operated on for acute type A aortic dissection during the period of the study, were developed by means of multivariate logistic regression with preoperative and intraoperative variables used as independent predictors of outcome.

Neri, E., Toscano, T., Massetti, M., Capannini, G., Carone, E., Tucci, E., et al. (2001). Operation for acute type A aortic dissection in octogenerians: is it justified?. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 121(2), 259-267 [10.1067/mtc.2001.112205].

Operation for acute type A aortic dissection in octogenerians: is it justified?

Neri E;SCOLLETTA, SABINO;
2001-01-01

Abstract

With the progressive aging of Western populations, cardiac surgeons are faced with treating an increasing number of elderly patients. Controversy exists as to whether the expenditure of health care resources on the growing elderly populations represents a cost-effective approach to resource management. The potential to avoid surgery in patients with little chance of survival and poor quality of life would spare unnecessary suffering, reduce operative mortality, and enhance the use of scarce resources. METHODS: We reviewed the records of 24 consecutive patients aged 80 years or older (mean age 83 years, range 80-93 years) who underwent operations for acute type A dissection from 1985 through 1999. No patient with acute type A dissection was refused surgery because of age or concomitant disease. Seventeen patients were men. Preoperatively, none of the patients was moribund, although 66% had hemodynamic instability and 41% experienced cerebral ischemia. All patients had one or more associated pathologic conditions. Hospital mortality and morbidity models, based on our overall experience with 197 patients operated on for acute type A aortic dissection during the period of the study, were developed by means of multivariate logistic regression with preoperative and intraoperative variables used as independent predictors of outcome.
2001
Neri, E., Toscano, T., Massetti, M., Capannini, G., Carone, E., Tucci, E., et al. (2001). Operation for acute type A aortic dissection in octogenerians: is it justified?. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 121(2), 259-267 [10.1067/mtc.2001.112205].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/40102
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