A systematic review on the quality of life and functional status after abdominal aortic aneurysm repair in elderly patients with an average age older than 75 years
| Autor: | Leonard Shan, Domenic R. Robinson, David Goh, Akshat Saxena |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Health Status medicine.medical_treatment Population Endovascular aneurysm repair Blood Vessel Prosthesis Implantation Aortic aneurysm Quality of life Risk Factors medicine Humans education Aged Aged 80 and over education.field_of_study business.industry Endovascular Procedures Age Factors medicine.disease Mental health humanities Abdominal aortic aneurysm Mental Health Treatment Outcome Clinical research Quality of Life Physical therapy Female Surgery Functional status Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Vascular Surgery. 69:1268-1281 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2018.09.032 |
| Popis: | Objective Endovascular aneurysm repair (EVAR) and open repair (OR) of abdominal aortic aneurysms (AAAs) are increasingly performed in elderly patients (>75 years of age) with satisfactory results. Quality of life (QOL) is increasingly considered a primary goal of intervention after AAA repair. However, there is currently no consensus on QOL after these procedures in elderly patients. Methods A systematic review was performed using strict eligibility criteria. Clinical studies reporting QOL in elderly patients (average age >75 years) after EVAR and OR were included. Quality appraisal and data tabulation were performed using predetermined forms. Data were synthesized by narrative review. Study quality was assessed. Results Thirteen studies with 1272 patients were included. After elective EVAR, disease-specific and generic QOL scores demonstrated an initial postoperative deterioration. By 4 to 6 weeks postoperatively, mental health components have improved to scores similar to or better than those at baseline. Physical health components take up to 3 months to return to baseline. After this, 36-Item Short-Form Health Survey and EuroQol-5 Dimension scores are maintained at preoperative levels for 1 to 3 years. In emergent EVAR, long-term survivors may have QOL comparable to that of the general population. Elective OR appears to have comparable QOL for up to 3 years compared with a matched population. QOL after emergent OR seems poor. Data on OR in elderly patients remain limited. Conclusions QOL after EVAR and OR declines early, with a 4- to 6-week delay in mental health recovery and 1- to 3-month delay in physical health recovery. QOL eventually returns to baseline and can be maintained in the long term. This review supports AAA repair in elderly patients from a QOL perspective. |
| Databáze: | OpenAIRE |
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