Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis

被引:2
|
作者
Frisiras, Angelos [1 ]
Giannas, Emmanuel [1 ]
Bobotis, Stergios [1 ]
Kanella, Ilektra [1 ]
Rad, Arian Arjomandi [2 ]
Viviano, Alessandro [3 ]
Spiliopoulos, Kyriakos [4 ]
Magouliotis, Dimitrios E. [5 ]
Athanasiou, Thanos [6 ]
机构
[1] Imperial Coll London, Charing Cross Hosp, Fac Med, London W6 8RF, England
[2] Univ Oxford, Med Sci Div, Oxford OX1 3AZ, England
[3] Hammersmith Hosp, Imperial Coll NHS Trust, Dept Cardiothorac Surg, London W12 0HS, England
[4] Univ Thessaly, Dept Cardiothorac Surg, Biopolis, Larisa 41110, Greece
[5] Univ Thessaly, Dept Cardiothorac Surg, Unit Qual Improvement, Biopolis, Larisa 41110, Greece
[6] Imperial Coll London, St Marys Hosp, Dept Surg & Canc, London W2 1NY, England
关键词
TEVAR; thoracic aorta; endovascular repair; elderly; age; morbidity; mortality; ENDOVASCULAR AORTIC REPAIR; THORACIC AORTA; RISK-FACTORS; ANEURYSMS; PATHOLOGY; SURVIVAL; COMPLICATIONS; ENDOLEAKS; REGISTRY; IMPACT;
D O I
10.3390/jcm12155001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Due to an ever-increasing ageing population and limited available data around the use of thoracic endovascular aortic repair (TEVAR) in elderly patients, investigating its efficacy and safety in this age cohort is of vital importance. We thus reviewed the existing literature on this topic to assess the feasibility of TEVAR in elderly patients with severe thoracic aortic pathologies. Methods: We identified all original research studies that assessed TEVAR in elderly patients published up to 2023. Morbidity, as assessed by neurological and respiratory complications, endoleaks, and length of stay, was the primary endpoint. Short-term mortality and long-term survival were the secondary endpoints. The Mantel-Haenszel random and fixed effects methods were used to calculate the odds ratios for each outcome. Further sensitivity and subgroup analyses were performed to validate the outcomes. Results: Twelve original studies that evaluated elective TEVAR outcomes in elderly patients were identified. Seven studies directly compared the use of TEVAR between an older and a younger patient group. Apart from a shorter hospital stay in older patients, no statistically significant difference between the morbidity outcomes of the two different cohorts was found. Short-term mortality and long-term survival results favoured the younger population. Conclusions: The present meta-analysis indicates that, due to a safe perioperative morbidity profile, TEVAR should not be contraindicated in patients based purely on old age. Further research using large patient registries to validate our findings in elderly patients with specific aortic pathologies and both elective and emergency procedures is necessary.
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页数:18
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