000			04585nam a22007457a 4500
008			160113s20142014 xxu||||| |||| 00| 0 eng d
022			_a0890-5096
040			_aOvid MEDLINE(R)
099			_a24189191
245			_aElective endovascular aneurysm repair in the elderly: trends and outcomes from the Nationwide Inpatient Sample.
251			_aAnnals of Vascular Surgery. 28(4):798-807, 2014 May.
252			_aAnn Vasc Surg. 28(4):798-807, 2014 May.
253			_aAnnals of vascular surgery
266			_d2016-01-13
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
520			_aCONCLUSIONS: EVAR is being performed with increasing frequency in patients older than 80 years, with one-quarter of EVAR performed in patients aged 80 years and older in the current sample. Although mortality rates remain acceptable in this elderly population, EVAR and OAR are associated with an age-dependent increase in death, complications, and discharge to extended care facilities. These factors, in addition to long-term risk of aneurysm rupture, should be considered when evaluating the appropriateness of elective aneurysm repair in the elderly.Copyright � 2014 Elsevier Inc. All rights reserved.
520			_aMETHODS: The Nationwide Inpatient Sample database was queried for elective AAA repair during 2005 to 2009. Number of EVAR cases, ratio of EVAR/open aneurysm repair (OAR), major clinical outcomes, and discharge status were analyzed by decade. Interval data were compared with analysis of variance (ANOVA) and proportions via chi-squared tests.
520			_aOBJECTIVES: This study attempted to identify trends in the use of endovascular aneurysm repair (EVAR) and outcomes in elective abdominal aortic aneurysm (AAA) repair over a 5-year period in a nationwide dataset, with specific attention to patients older than 80 years.
520			_aRESULTS: A total of 174,714 AAA repairs (124,869 EVARs) were identified. The ratio of EVAR/OAR increased with increasing age. Between 2005 and 2009, the total number of AAA repairs increased by 21% (7,179 vs. 8,554) and EVARs increased by 50% (5,057 vs. 7,650; P < 0.05) in patients older than 80 years. In 2009, 85% of AAA repairs in patients older than 80 years were EVARs. Patients older than 80 years constituted 25% of the total EVAR cohort. Although the in-hospital mortality rate remained acceptable in all age groups, EVAR-associated mortality, length of stay, and discharge to a skilled nursing facility increased with each successive decade of life (P < 0.05). Rates of postoperative myocardial infarction and acute renal failure also increased with increasing age (P < 0.05). EVAR results are presented by decade.
546			_aEnglish
650			_a*Aortic Aneurysm, Abdominal/su [Surgery]
650			_a*Blood Vessel Prosthesis Implantation/td [Trends]
650			_a*Endovascular Procedures/td [Trends]
650			_a*Inpatients
650			_aAcute Kidney Injury/et [Etiology]
650			_aAge Factors
650			_aAged
650			_aAged, 80 and over
650			_aAortic Aneurysm, Abdominal/mo [Mortality]
650			_aBlood Vessel Prosthesis Implantation/ae [Adverse Effects]
650			_aBlood Vessel Prosthesis Implantation/mo [Mortality]
650			_aChi-Square Distribution
650			_aDatabases, Factual
650			_aElective Surgical Procedures
650			_aEndovascular Procedures/ae [Adverse Effects]
650			_aEndovascular Procedures/mo [Mortality]
650			_aFemale
650			_aHospital Mortality
650			_aHumans
650			_aLength of Stay
650			_aMale
650			_aMiddle Aged
650			_aMultivariate Analysis
650			_aMyocardial Infarction/et [Etiology]
650			_aPatient Discharge
650			_aPatient Selection
650			_aRisk Assessment
650			_aRisk Factors
650			_aTime Factors
650			_aTreatment Outcome
650			_aUnited States
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aSurgery/Vascular Surgery
657			_aComparative Study
657			_aJournal Article
657			_aObservational Study
700			_aAzefor, Nchang M
700			_aHuang, Chun Chih
700			_aPark, Brian D
700			_aRicotta, John J
790			_aAzefor NM, Huang CC, Park BD, Ricotta JJ
856			_uhttp://dx.doi.org/10.1016/j.avsg.2013.07.029 _zhttp://dx.doi.org/10.1016/j.avsg.2013.07.029
942			_cART _dJournal article
999			_c12251 _d12251