Aim: Age is one of the risk factors for postoperative complications in open surgery of the aorta. The awareness of their frequency may lead to earlier diagnosing and referral for procedure in order to avoid negative results of surgery and further therapy.
Introduction: The aim of our study was to assess the dependent of age frequency of postoperative complications among patients undergoing primary open surgical procedure within abdominal aorta due to aneurysm (AAA) or/and peripheral arterial disease (PAD).
Methods: The study group consisted of 249 patients (84.7% men), aged 69.1±8.2 with AAA or/and PAD who underwent open abdominal aorta surgery between August 2015 and January 2017. Patients were divided into three groups depending on age group I<65 years (61 patients, aged 58.8±5), group II 65–74yrs (118 patients, aged 68.5±2.8) and group III >74yrs (70 patients, aged 79.1±3.4). We considered coexistent diseases, smoking habit, Revised Cardiac Risk Index for Pre-Operative Risk (Lee index), some laboratory tests, type and mode of surgery (elective vs urgent/emergent). Statistical analysis was performed with Kruskall Wallis and Chi2 tests.
Results: Frequency of some complications such as myocardial infarction, pneumonia, sepsis, stroke or bleeding was similar in compared groups. Nevertheless, we observed a statistically significant difference in the frequency of acute kidney injury undemanding dialysis (respectively, for groups I–III: 3.28% vs. 17.80% vs. 20.00%; p=0.013), multi-organ failure (1.64% vs. 10.17% vs. 14.29%; p=0.039) and intrahospital mortality (1.64% vs. 11.86% vs. 18.57%; p=0.009). The groups were comparable regarding the coexistent diseases – the only differentiative feature was hypertension that occurred less in group I (62.30%) than in other groups (82.20% and 81.43%, p=0.01). There was no significant difference between groups in preoperative risk determined by Lee index and mode of surgery procedure. However, older patients had higher mean creatine level on admission than younger patients (72.2±21.5 vs. 91.3±34.2 vs. 94.4±37.7umol/l, p<0.005), lower eGFR (109±31 vs. 84.5±29.1 vs. 73.8±24.7ml/min/1.73m2, p<0.001) and more often underwent procedure due to ruptured aneurysm (4.92% vs. 9.32% vs. 11.43%, p<0.001).
Conclusion: Age is a significant feature which increases the frequency of acute kidney injury, multi-organ failure and intrahospital mortality in compared group despite similar coexistent diseases, mode of surgery and preoperative risk determined by Lee index.1,2