Postendarterectomy mortality in octogenarians and nonagenarians in the USA from 1993 to 1999.
Postendarterectomy mortality in octogenarians and nonagenarians in the USA from 1993 to 1999.
复制标题
1993 年至 1999 年美国八旬老人和九十岁老人动脉内膜切除术后死亡率。
DOI：
10.1159/000262312
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Goldstein,LarryB
中科院分区：
文献类型：
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作者：
Lichtman,JudithH;Jones,SaraB;Wang,Yun;Watanabe,Emi;Allen,NorrinaB;Fayad,Pierre;Goldstein,LarryB
背景：对高龄患者颈动脉内膜切除术（CEA）的使用趋势或结果知之甚少。我们确定了CEA和围手术期（住院和30天）和长期在美国全国样本中，年龄> 80岁的患者（1年、2年、3年、4年和5年）死亡率。（80-89岁和90 - 90岁）患有CEA [ICD-9-CM（国际疾病分类，第九次修订，临床修改）：38.12] 1993年至1999年使用医疗保险和医疗补助服务住院患者标准分析文件中心确定。人口统计学特征和共病的条件下，确定使用ICD-9-CM诊断代码在一年内的索引住院CEA.Results：共140,376 CEA进行的患者年龄在80-89岁和6,446在那些年龄在90岁以上在这7年期间。老年人每年的手术次数从1993年的13 115次增加到1999年的21 582次，90岁以上的从1993年的481次增加到1999年的1 257次。围手术期死亡率为2.2%的老年人和3.3%的90岁以上。术后长期死亡率每年增加约10%，5年时，老年人为43%，90岁以上为56%。围手术期死亡率保持相对稳定，在7年的时间为两个年龄组，虽然合并症increased.Conclusions：CEA在美国的老年人进行的数量增加，从1993年至1999年。与试验结果相比，围手术期死亡率较高，而长期生存率与美国同龄人相当。
Background:Relatively little is known about trends in the utilization or outcomes of carotid endarterectomy (CEA) in the very elderly. We determined trends in the rates of CEA and perioperative (in-hospital and 30-day) and long-term (1-, 2-, 3-, 4- and 5-year) mortality in a US national sample of patients ≧80 years of age.Methods:All fee-for-service Medicare patients (80–89 and ≧90 years of age) who had a CEA [ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification): 38.12] from 1993 to 1999 were identified using the Centers for Medicare and Medicaid Services Inpatient Standard Analytic Files. Demographic characteristics and comorbid conditions were determined using ICD-9-CM diagnostic codes within the year prior to the index hospitalization for CEA.Results:A total of 140,376 CEA were performed in patients aged 80–89 years and 6,446 in those aged ≧90 years during this 7-year period. The annual number of operations increased from 13,115 in 1993 to 21,582 in 1999 for octogenarians, and from 481 in 1993 to 1,257 in 1999 for nonagenarians. Perioperative mortality was 2.2% in octogenarians and 3.3% in nonagenarians. Long-term mortality increased by approximately 10% per year after the operation, and was 43% in octogenarians and 56% in nonagenarians at 5 years. Perioperative mortality rates remained relatively stable over the 7-year period for both age groups although comorbidities increased.Conclusions:The number of CEA performed in the very elderly in the USA increased from 1993 to 1999. Perioperative mortality rates were high compared with trial results, while long-term survivorship was comparable to that of similarly-aged peers in the USA.