Physical activities and surgical outcomes in elderly patients with acute
type A aortic dissection
Abstract
Objective: Although elderly patients undergoing surgery for acute type A
aortic dissection (ATAAD) is increasing, their physical activities are
not fully understood. We report the physical activities and surgical
outcomes in the elderly patients who underwent ATAAD. Methods: From 2009
to 2019, 103 consecutive patients underwent surgery for ATAAD at our
institution. Surgical outcomes along with pre- and postoperative
physical activities in 52 elderly patients (≥70 years old) were compared
with those in 51 younger patients (<70 years old).
Postoperative walking difficulty was defined as taking ≥30 days to
regain the ability to walk 200 m postoperatively or as the inability to
walk at discharge. Results: It took longer for elderly patients to
regain the ability to walk 100 or 200 m postoperatively. ROC analysis
revealed the AUC of the duration for walking 200 m postoperatively as a
prognostic indicator for late deaths was 0.878, with the highest
accuracy at 30 days (sensitivity = 83.3%, specificity = 91.8%).
Hospital mortality within 30 days was 3.8%, and 1-, 3-, and 5-years
survival rates were 92%, 84.7%, 84.7%, respectively, for elderly
patients, with no significant differences between groups. Cox
proportional hazard analysis showed postoperative walking difficulty was
an independent risk factor for late mortality in all cohorts (P =
0.017). Conclusions: Elderly patients undergoing surgical ATAAD repair
showed acceptable surgical outcomes. However, they were more likely to
decrease their physical activities postoperatively. Postoperative
difficulty in walking was an independent risk factor for the late
mortality in patients with ATAAD.