Long-term survival following repair of ruptured abdominal aortic aneurysm in patients over 75 years of age

BACKGROUND: Previous studies have indicated that patients over the age of 75 years have an increased in-hospital mortality rate following repair of ruptured abdominal aortic aneurysm (AAA). The long-term survival of this patient group has not been reported previously, even though this information may have a strong influence on the decision to operate. METHODS: Interrogation of a prospective database identified 272 patients aged 75 years or over (median age 78 (range 75-93) years) admitted between 1983 and 1995. Long-term patient survival data and survival curves for an age- and sex-matched population were obtained from the General Register Office through the Information and Statistics Division. RESULTS: Sixty-nine (25 per cent) of the 272 patients did not undergo operation. Eighty-eight (43 per cent) of the 203 patients who had surgery died within the same hospital admission. The 1-, 5- and 10-year survival rates for the remaining 115 patients (median age 77 (range 75-85) years) were 88, 59 and 26 per cent respectively, at a median follow-up of 54 (range 1-157) months. The median life expectancy for this patient group was 69 months. These data are comparable to those of an age- and sex-matched population. CONCLUSION: Many patients over the age of 75 years who present with ruptured AAA are considered unfit for surgery. These data demonstrate that, even in this elderly population, survivors of ruptured AAA repair enjoy a near-normal life expectancy.