Aortic aneurysm trials in octogenarians: Are we really measuring the outcomes that matter?

S J Aitken; V Naganathan; F M Blyth

doi:10.1177/1708538115597079

Aortic aneurysm trials in octogenarians: Are we really measuring the outcomes that matter?

Vascular. 2016 Aug;24(4):435-45. doi: 10.1177/1708538115597079. Epub 2015 Jul 28.

Authors

S J Aitken¹, V Naganathan², F M Blyth³

Affiliations

¹ Concord Clinical School, Professorial Surgery Unit, Department of Vascular Surgery, New South Wales, Australia sarah.aitken@sydney.edu.au.
² Concord Clinical School, Centre for Education and Research on Ageing, Concord, Sydney, New South Wales, Australia.
³ Concord Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.

PMID: 26223531
DOI: 10.1177/1708538115597079

Abstract

Purpose: This study is a systematic review to determine the types of outcomes reported in abdominal aortic aneurysm (AAA) studies of patients aged 80 and over. Specifically, it determines the types of patient-centered outcomes reported.

Method: MEDLINE and EMBASE were searched from 2000 to 2014 for studies on AAA surgery with outcome data on patients aged 80 and over. Outcomes were categorized according to Donabedian's framework for health quality indicators, with further classification as procedural, complication, resource or patient-centered outcome indicators.

Findings: Forty studies were reviewed. Patient-centered outcomes were infrequently reported (13%, n=5), with limited outcomes specifically relevant to older patients. No studies reported physical function, activities of daily living or cognition using validated assessment methods. Short-term mortality (95%, n=38) and complications (85%, n=34) were reported most frequently.

Conclusion: Reporting of aortic surgery outcomes in patients aged 80 and over requires a focus upon outcomes of primary importance to people of this age.

Keywords: 80 and over; Patient outcome assessment; abdominal; aged; aortic aneurysm; health care; patient-centered care; quality indicators; review; systematic.

Publication types

Review
Systematic Review

MeSH terms

Age Factors
Aged, 80 and over
Aortic Aneurysm, Abdominal / diagnostic imaging
Aortic Aneurysm, Abdominal / mortality
Aortic Aneurysm, Abdominal / surgery*
Clinical Trials as Topic / methods*
Endovascular Procedures* / adverse effects
Endovascular Procedures* / mortality
Endpoint Determination*
Female
Humans
Male
Patient Outcome Assessment*
Process Assessment, Health Care*
Risk Factors
Treatment Outcome
Vascular Surgical Procedures* / adverse effects
Vascular Surgical Procedures* / mortality