Evidence map›Paper›PMID 39305305›Full record

Observational studyAge and ageing2024

Preoperative clinical characteristics and 12-month outcomes following operative or non-operative management of asymptomatic aortic aneurysms.

Phoebe Scarfield, Amy R Sharkey, Jugdeep K Dhesi, Bijan Modarai, Mark R Tyrrell, Judith S L Partridge

Abstract readObservational Study
In one paragraph

Observational study in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Phoebe ScarfieldPerioperative Medicine for Older People Undergoing Surgery (POPS), Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK.ORCID 0000-0002-9258-2532
Amy R SharkeyDepartment of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 9RT, UK.
Jugdeep K DhesiHonorary Professor, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, WC2R 2LS, UK.
Bijan ModaraiConsultant Vascular Surgeon, Guy's & St. Thomas' NHS Trust, SE1 7EH.
Mark R TyrrellConsultant Vascular Surgeon, Guy's & St. Thomas' NHS Trust, SE1 7EH.
Judith S L PartridgeConsultant Geriatrician, Perioperative Medicine for Older People Undergoing Surgery (POPS), Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

designAn observational cohort study conducted at a tertiary referral center for aortic surgery to describe the medical and surgical characteristics of patients assessed for abdominal aortic aneurysm repair and examine associations with 12-month outcome.

methodsPatients with aortic aneurysms referred for discussion at the aortic multidisciplinary meeting (MDM). Data were collected via a prospectively maintained clinical database and included aneurysm characteristics, patient demographics, co-morbidities, geriatric syndromes, including frailty, management decision and 12-month mortality, both aneurysm-related and all-cause including cause of death. The operative and non-operative groups were compared statistically.

results621 patients referred to aortic MDM; 292 patients listed for operative management, 141 patients continued on surveillance, 138 patients for non-operative management. There was a higher 12-month mortality rate in the non-operative group compared to the operative group (41% vs 7%, P = <0.001). In the non-operative group, 16 patients (29%) died of aneurysm rupture within 12 months, with 39 patients (71%) dying from other medical causes. Non-operatively managed patients were older, more likely to have cardiac and respiratory disease and more likely to be living with frailty, cognitive impairment and functional limitation, compared to the operative group.

conclusionThis study shows that preoperative geriatric syndromes and increased comorbidity lead to shared decision to non-operatively manage asymptomatic aortic aneurysms. Twelve-month mortality is higher in the non-operative group with the majority of deaths occurring due to cause other than aneurysm rupture. These findings support the need for preoperative comprehensive geriatric assessment followed by multispecialty discussion and shared decision making.

Indexed as

Aortic Aneurysm, AbdominalAgedAged, 80 and overAge FactorsAsymptomatic DiseasesCause of DeathComorbidityFemaleFrailtyHumansMaleMiddle AgedRisk FactorsTime FactorsTreatment OutcomeVascular Surgical Proceduresaortic aneurysm repairaortic multidisciplinary meetingcomprehensive geriatric assessmentolder peoplerealistic medicineshared decision making

Identifiers

PMID39305305
PMCPMC11416039

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.