loading page

Physical activities and surgical outcomes in elderly patients with acute type A aortic dissection
  • +4
  • Yasushi Tashima,
  • Yurie Toyoshima,
  • Kota Chiba,
  • Noriyuki Nakamura,
  • Koichi Adachi,
  • Yoshimitsu Inoue,
  • Atsushi Yamaguchi
Yasushi Tashima
Yokosuka General Hospital Uwamachi
Author Profile
Yurie Toyoshima
Yokosuka General Hospital Uwamachi
Author Profile
Kota Chiba
Yokosuka General Hospital Uwamachi
Author Profile
Noriyuki Nakamura
Yokosuka General Hospital Uwamachi
Author Profile
Koichi Adachi
Yokosuka General Hospital Uwamachi
Author Profile
Yoshimitsu Inoue
Yokosuka General Hospital Uwamachi
Author Profile
Atsushi Yamaguchi
Jichi Medical University, Saitama Medical Center
Author Profile

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.

Peer review status:ACCEPTED

15 Dec 2020Submitted to Journal of Cardiac Surgery
17 Dec 2020Submission Checks Completed
17 Dec 2020Assigned to Editor
18 Dec 2020Reviewer(s) Assigned
11 Jan 2021Review(s) Completed, Editorial Evaluation Pending
12 Jan 2021Editorial Decision: Revise Major
29 Jan 20211st Revision Received
09 Apr 2021Submission Checks Completed
09 Apr 2021Assigned to Editor
12 Apr 2021Reviewer(s) Assigned
20 Apr 2021Review(s) Completed, Editorial Evaluation Pending
20 Apr 2021Editorial Decision: Accept