Aneurysms In Elderly Research Articles

567 Drivers of 30-day Readmission, Drivers of 30-day Readmission, Reoperation, and Length of Stay Following Clipping Surgery of Unruptured Aneurysms in Elderly: A National Surgical Quality Improvement Program (NSQIP) Study

INTRODUCTION: Elderly population is increasing worldwide with a consistent increase in the incidence of aneurysms. There are limited data evaluating the rate and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms in elderly. METHODS: Data on elderly patients (≥65 years) who underwent surgical clipping of an unruptured aneurysm between 2016 and 2020 were extracted from the prospective National Surgical Quality Improvement Program registry (NSQIP). Multivariable logistic regression evaluated the independent predictors of nonroutine hospital discharge, length of stay (LOS), 30-day reoperation, and readmission. Shapley additive explanations (SHAP) were calculated for feature importance using the best-performing model. RESULTS: A total of 367 elderly patients underwent surgical clipping for both ruptured (N = 142) and unruptured aneurysms (N = 225). Among the 225 unruptured cases, 11.6% (N=26) were readmitted and 6.2% (N = 14) were reoperated after 30 days. The mean LOS is 6.53 days (± 7.15). Most patients were discharged home (N = 160; 71.1%). Morbidity and morbidity probabilities were 2.15% and 3.8%, respectively. Male sex; preoperative BUN; preoperative creatinine and preoperative platelet count (p < 0.05) are more likely to predict 30-day readmission. Male sex, history of cancer , and history of COPD (p < 0.05) are more likely to predict reoperation. LOS was predicted with simple aneurysm , history of sepsis; history of COPD; elective surgery; operative time and days till the operation (p < 0.05). Machine learning using SHAP showed that BUN, platelet count, and sex had the highest impact on readmission; WBC, hematocrit, and sodium levels had the highest impact on reoperation; while operative time and history of sepsis had the highest impact on LOS. CONCLUSIONS: Our predictive model validates risk stratification of outcomes of patients undergoing microsurgical clipping of unruptured cerebral aneurysms in the elderly.

Surgical Treatment of Intracranial Aneurysms in Elderly

Introduction: Twenty years ago, elderly patients who had a diagnosis of intracerebral aneurysms were considered to have a poor prognosis and, thus, were excluded of any kind of treatment. With the rapid aging of the population, there was a consistent increase on the prevalence of subarachnoid hemorrhage and, consequently, all of its complications. Delayed neurological deterioration from cerebral arterial vasospasm is a major cause of morbidity and mortality. Thus, specific treatment strategy for intracranial aneurysms in the elderly has been developed. Materials and Methods: Analysis of medical records, office charts, and imaging studies of all elderly patients who underwent surgical treatment of intracerebral aneurysms, and review of literature. Data related to these patients, like gender, aneurysm location, rupture, and comorbidities, were recorded. Results: Between June 1996 and November 2009, among 152 patients with 209 ruptured and unruptured intracranial aneurysms treated surgically, 23 patients were 65 years of age or older. Discussion: Withholding aneurysm surgery merely because of the patient’s age is not necessarily the most appropriate decision. Early surgery, in order to avoid re-rupture, vasospasm and infection, still is the better decision, independently of the treatment modality - open surgery or endovascular.

Evidence-based screening for abdominal aortic aneurysms in elderly

Abdominal aortic aneurysms(AAAs) is the most common aneurysm, and usually characterized by less symptom. While ruptured AAAs leads to high mortality. Abdominal ultrasonography can effectively detect AAA, decrease the AAAs-related mortality. However, screening AAAs causes some adverse outcomes, including psychological distress and immediate harms in treatment. Meanwhile, the prevalence of AAAs in sex and age is significantly different. Therefore, a reasonable and effective screening strategy is very important. This article search random control trials, systematic reviews, meta-analysis and guidelines in screening AAAs to obtain a reasonable screening strategy. Key words: Abdominal aortic aneurysms; Screening; Strategy

Renal Cysts as Strongest Association with Abdominal Aortic Aneurysm in Elderly

Renal Cysts as Strongest Association with Abdominal Aortic Aneurysm in Elderly

Room C, 10/16/2000 2: 00 PM - 4: 00 PM (PS) Atrial Septal Aneurysms in Elderly Cardio-Vascular Surgical Patients

Room C, 10/16/2000 2: 00 PM - 4: 00 PM (PS) Atrial Septal Aneurysms in Elderly Cardio-Vascular Surgical Patients