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.

ABSTRACT

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.