P316. Surgical Outcomes and Quality of Life After Aortic Surgery in Octogenarians
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Sheffield Teaching Hospitals NHS Foundation Trust
United Kingdom - Contact Me
Specialty Registrar in Cardiothoracic Surgery, UK
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objectives:
Considering longer life expectancy of the population, octogenarians represent a new challenge in aortic surgery. Aortic surgery in elderly patients is associated with high rates of postoperative morbidity and mortality. Considering the current pressure on the national health system and the limited hospital resources, offering major aortic surgery to this group of patients remains controversial. One of the main preconceptions is the expected poor quality of life after surgery.
Methods:
We prospectively collected data of 800 consecutive patients who underwent major aortic surgery between 2011 and 2023. Forty-five patients (5.6%) were octogenarians. The median age was 82 years (80-87 years). Preoperative, operative, postoperative and follow-up data were prospectively collected in our hospital database. Quality of life at follow-up was assessed trough a telephone questionnaire.
Results:
Twenty-two patients (48.9%) required emergency surgery. The main indications for aortic surgery were ascending aortic aneurysm in 48.9%, acute aortic syndrome in 22.2% and chronic aortic syndrome in 6.7%. Five patients (11.1%) had surgery of the aortic root, 37 (82.2%) of the ascending aorta and 9 (20%) of the arch.
In-hospital mortality was 26.6%, incidence of stroke 11% and average length of hospital stay 21 days (7-139 days).
Overall survival at 1 and 3 years was 64.4% and 51.1%.
15 patients were alive at the time of QOL assessment and 10/15 completed the questionnaire. 80% of the patients had a full recover after surgery; less than 20% suffered a major complication after discharge, 70% graded their quality of life >4 in a scale 1 to 5; 80% had same or better quality of life compared to prior surgery and all the patients would have their aortic surgery again.
Conclusion:
Octogenarians undergoing aortic surgery have high incidence of post-operative complications with 26.6% mortality and 11% stroke. Despite high peri-operative mortality, the late survival was encouraging with a 3 years survival rate of 51.1% The patients who survived aortic surgery maintained a good quality of life. All the patients who completed the QOL questionnaire would have the aortic surgery again if they had the opportunity to go back in time.
Authors
Mohamed Shoeib (1), Sumit Das (2), Syed Sadeque (3), Govind Chetty (3), Stefano Forlani (4), Graham Cooper (5), Renata Greco (6)
Institutions
(1) Sheffield Teaching Hospitals, Sheffield, (2) Sheffield teaching Hospitals, Sheffield, NA, (3) Sheffield Teaching Hospitals, Sheffield, NA, (4) Sheffield Teaching Hospitals, Sheffield, United Kingdom, (5) Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, NA, (6) Sheffield Teaching Hospital, Sheffield
Considering longer life expectancy of the population, octogenarians represent a new challenge in aortic surgery. Aortic surgery in elderly patients is associated with high rates of postoperative morbidity and mortality. Considering the current pressure on the national health system and the limited hospital resources, offering major aortic surgery to this group of patients remains controversial. One of the main preconceptions is the expected poor quality of life after surgery.
Methods:
We prospectively collected data of 800 consecutive patients who underwent major aortic surgery between 2011 and 2023. Forty-five patients (5.6%) were octogenarians. The median age was 82 years (80-87 years). Preoperative, operative, postoperative and follow-up data were prospectively collected in our hospital database. Quality of life at follow-up was assessed trough a telephone questionnaire.
Results:
Twenty-two patients (48.9%) required emergency surgery. The main indications for aortic surgery were ascending aortic aneurysm in 48.9%, acute aortic syndrome in 22.2% and chronic aortic syndrome in 6.7%. Five patients (11.1%) had surgery of the aortic root, 37 (82.2%) of the ascending aorta and 9 (20%) of the arch.
In-hospital mortality was 26.6%, incidence of stroke 11% and average length of hospital stay 21 days (7-139 days).
Overall survival at 1 and 3 years was 64.4% and 51.1%.
15 patients were alive at the time of QOL assessment and 10/15 completed the questionnaire. 80% of the patients had a full recover after surgery; less than 20% suffered a major complication after discharge, 70% graded their quality of life >4 in a scale 1 to 5; 80% had same or better quality of life compared to prior surgery and all the patients would have their aortic surgery again.
Conclusion:
Octogenarians undergoing aortic surgery have high incidence of post-operative complications with 26.6% mortality and 11% stroke. Despite high peri-operative mortality, the late survival was encouraging with a 3 years survival rate of 51.1% The patients who survived aortic surgery maintained a good quality of life. All the patients who completed the QOL questionnaire would have the aortic surgery again if they had the opportunity to go back in time.
Authors
Mohamed Shoeib (1), Sumit Das (2), Syed Sadeque (3), Govind Chetty (3), Stefano Forlani (4), Graham Cooper (5), Renata Greco (6)
Institutions
(1) Sheffield Teaching Hospitals, Sheffield, (2) Sheffield teaching Hospitals, Sheffield, NA, (3) Sheffield Teaching Hospitals, Sheffield, NA, (4) Sheffield Teaching Hospitals, Sheffield, United Kingdom, (5) Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, NA, (6) Sheffield Teaching Hospital, Sheffield
Presentation Duration
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