https://scholars.lib.ntu.edu.tw/handle/123456789/559935
標題: | Is old age a contraindication for surgical treatment in acute aortic dissection? A demographic study of national database registry in Taiwan | 作者: | I-HUI WU HSI-YU YU Liu C.-H. YIH-SHARNG CHEN SHOEI-SHEN WANG Lin F.-Y. |
公開日期: | 2008 | 卷: | 23 | 期: | 2 | 起(迄)頁: | 133-139 | 來源出版物: | Journal of Cardiac Surgery | 摘要: | Background: Acute aortic dissection is usually presented as a surgical emergent condition with high mortality rate. Whether any patient of an advanced age suffering from acute aortic type A dissection or complicated type B dissection should be referred for surgery still deserves debating. Materials and Methods: A retrospective study including 5654 patients with acute aortic dissection was collected from the National Health Insurance Databases from 1996 to 2001. Age, initial treatment modality, and the late outcome were the main factors to be investigated. Patients are grouped into the young age group when ages are less or equal to 70 and the old age group when over 70. We further subdivided both groups into operative and nonoperative subgroups, respectively, depending on patients receiving surgical intervention for acute aortic dissection or not. The endpoint mortality was defined by the patient death either related to or unrelated to cardiac causes. Results: A total of 5654 cases are with the mean age of 65.6 ± 14.0 years. The percentage of patients receiving operation was inversely related to the patient's age significantly (p < 0.05). In the old age group, the operative subgroup had both significantly higher survival rate at six-year follow-up than the nonoperative group for both patients on admission and 30-day survivors (43.4 ± 3.5% vs. 29.8 ± 2.3%, p < 0.05; 70.0 ± 4.5% vs. 36.0 ± 2.8%, p < 0.05). The annual attrition rates of mortality were significantly higher in the nonoperative subgroup for both patients on admission and 30-day survivors (p < 0.05). Conclusion: The trend toward more conservative treatment in the elderly still occurs in our common practice even with improving surgical techniques. In our study, we suggest that pertinent surgical strategies for acute aortic dissection are necessary to improve the outcome in elderly patients. ? 2008 by Blackwell Futura Publishing, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-39849092409&doi=10.1111%2fj.1540-8191.2007.00565.x&partnerID=40&md5=d4f97b2d68f41fbdf7221413543771b2 https://scholars.lib.ntu.edu.tw/handle/123456789/559935 |
ISSN: | 0886-0440 | DOI: | 10.1111/j.1540-8191.2007.00565.x | SDG/關鍵字: | adult; aged; aorta dissection; article; controlled study; female; human; major clinical study; male; patient care; senescence; surgical technique; survival rate; thoracic aorta surgery; treatment contraindication; treatment outcome; Acute Disease; Adult; Age Factors; Aged; Aged, 80 and over; Aneurysm, Dissecting; Aortic Aneurysm, Thoracic; Decision Making; Female; Geriatric Assessment; Humans; Insurance, Health; Male; Middle Aged; Postoperative Period; Registries; Retrospective Studies; Survival Analysis; Taiwan; Time Factors; Treatment Outcome |
顯示於: | 醫學系 |
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