Turkish Journal of Geriatrics 2000 , Vol 3, Issue 1
COMPARISON OF THE RESULTS OF SURGICAL THERAPY IN ACUTE SCHEMIA OF THE EXTREMITIES IN THE ELDERLY AND YOUNGER PATIENTS
Erdoğan İBRİŞİM, Ahmet ÖCAL, Turhan YAVUZ, Ali KUTSAL
Süleyman Demirel Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı Isparta For the comparison of the results of the surgical correction of acute extremity ischemia in the young and geriatric patients; 128 tromboembolectomy were performed in 104 cases between 1991 and 1999. 68 patients were in the geriatric and 36 cases were in the younger age group (38 males, 66 females). Acut ischemia was at upper extremities in 22, and at the lower extremities in 82 cases. Mean age was 68.5 in the geriatric, and 54.5 in the younger group. All cases were operated with local anesthesia. Amputation were performed in 8 cases. 5 cases had died in the early postoperative period, and all of them were in the geriatric group. 38 patients in geriatric and 6 patients in the younger group had atrial fibrillation due to ischemic heart disease, 11 patients in the geriatric group and 9 patients in the younger group had atrial fibrillation due to valvular heart disease. 2 patients had mitral valve replacement. Acute thrombotic occlusion at the cite of atherosclerotic plaque was observed in 8 cases and neither any predisposition nor any cause was found in 19 patients. Fisher's exact test was applied and no statistical significance was found between the mortality and amputation rates of the two groups. But as all the mortality was in the geriatric group it seems that there will be a statistical significance if the study will be carried out in larger series. The cardiac and renal disorders that may occur in higher rates in the geriatric group play an important role in the mortality. The most important factor that may increase the amputation rate is the duration of ischemia. Keywords : Geriatrics, Thromboembolectomy, Acute ischemia, Elderly