Risk assessment and feasibility assessment of aortic aneurysm surgery in elderly patients

Research Project

Project/Area Number	16K10650
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Cardiovascular surgery
Research Institution	Akita University
Principal Investigator	Yamamoto Hiroshi 秋田大学, 医学系研究科, 教授 (10270795)
Project Period (FY)	2016-04-01 – 2019-03-31
Project Status	Completed (Fiscal Year 2018)
Budget Amount *help	¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000) Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000) Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2016: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Keywords	大動脈手術 / 高齢者 / 手術限界年齢 / 胸部大動脈手術 / 腹部大動脈手術 / 大動脈疾患 / 緊急手術 / 術後QOL / 手術適応限界 / 外科的治療 / 術後遠隔成績 / QOL
Outline of Final Research Achievements	We performed risk assessment and feasibility assessment in elderly patients undergoing surgery for aorti caneurysm. In patients who underwent aortic surgery between 2009 and 2018, the patients were survayed in terms of postoperative QOL (SF-36) and the age limitation (the oldest age that the patients want to have surgery) by a questionale method. <Results> The patients are thinking that there is no limitaion of age in undergoing aortic surgery as long as they can keep physical activities after surgery. The patients older than 80 years old had poorer QOL (physical factor) compared with younger patients refardless of conditions with or without underging aortic surgery. <Conclusion> Aortic surgery seems to have no harmful effects on postoperative QOL in elderly patients compared with elderly patients who did not have aortic surgery.
Academic Significance and Societal Importance of the Research Achievements	大動脈手術においては全ての年齢群で希望年限に上限はなく、自身の身体的活動度に依存する返答（体力維持が可能な時期、立位歩行が可能な時期）であった。また年齢を経ることにより、家人との金銭、身体的負担を強いることを懸念したり、自己判断ではなく家人と相談という返答も認められた。また医学的知識がないため判断材料は少なく、医師の判断に任せるという意見も少なからず認められ、手術介入の判断の困難さが浮き彫りとなった。手術介入による術後QOLの低下は、手術を受けない加齢によるQOLの低下と差が認められず、現時点における大動脈手術の影響は大きくないと推察され、医学的見地から決定することが妥当と考える。