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Geriatric Vascular Surgery OBL: What Is Different? What Is Unknown?
Olga Bakayev, MD
1, Oscar Moreno, MD
2, Peter Deckerman, BS
1, Bairta Sangadzhieva, MD
1, Chiamaka Uzoma, MD
1, Said Ashkar, BS
1, Peter Awad, BS
1, Sundeep Srivastava, MD
1, Alexis Roth, MD
3, Natalie Marks, MD
1, Enrico Ascher, MD
1, Anil Hingorani, MD
4.
1Total Vascular Care, Brooklyn, NY, USA,
2University of Michigan, Ann Arbor, MI, USA,
3SUNY Downstate Health Sciences University, Brooklyn, NY, USA,
4NYU Langone, Brooklyn, NY, USA.
OBJECTIVES: As the population ages, the discrepancy between life expectancy and disability-free life span becomes crucial, particularly in geriatric care. With advancements in medical science pushing life expectancy higher, the quality of those added years remains questionable. In our article, we explore the evolving role of vascular surgery in managing the elderly population, evaluating whether current treatment methodologies adequately address their needs, and discuss potential strategic shifts in clinical approaches.
METHODS: This retrospective cohort study analyzed 937 patients who visited an outpatient facility from 2022 to 2024, categorized into age groups 60-79 (n=671) and 80-99 (n=266). We evaluated demographic, medical, and surgical variables using consecutive data extracted from the facility’s Electronic Medical Records. Descriptive statistical comparisons were performed between the age groups to identify significant differences. Rate of angiograms and vein closures across the groups were for group 60-79: 5.9% and 8.7%, for group 80-99: 4.4% and 6.9% respectively.
RESULTS: Within the study populations, the mean age (76 years) and sex ratio (53% male) were similar. However, when comparing 60-79 against 80-99, there was a more significant proportion of patients with anticoagulation therapy (21.1% vs 38.2%), mobility limitations (12.2% vs 39.9%) and cognitive impairment (2% vs 10.7%). Pearson's R (0.161) test and Spearman Correlation (0.158) indicate a moderate positive linear relationship between age and diabetes (p-value < 0.001). No significant difference was identified in the rate of recanalization or restenosis between the two age groups.
CONCLUSIONS: Despite the 80-99 group than 60-79 exhibiting higher rates of anticoagulation use, comorbidities, and cognitive limitations, we observed no significant increase in procedural complications. This likely reflects a careful selection of candidates for procedures among older adults. The majority of the study populations were treated conservatively. Further analysis will extend to additional age groups to confirm these trends.
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