Rehabilitation outcomes
The rehabilitation outcomes were compared between the groups to assess their physical activities among the patients regaining ambulatory autonomy at discharge (30 patients in the elderly group, and 37 patients in the control group). Preoperative characteristics and operative details in patients are presented in Supplemental Table 1 and Supplemental Table 2. Rehabilitation outcomes in patients regaining ambulatory autonomy at discharge are presented in Table 3. During rehabilitation, it was likely that elderly patients took longer to walk 100 or 200 m postoperatively (P = 0.024 and P = 0.025, respectively); although, there was no difference in postoperative walking difficulty between the groups. Elderly patients required significantly more speaking and swallowing therapy after surgery (P = 0.043). However, the length of ICU stay and the total hospitalization were not significantly different between the groups. There was no difference in communicating dissection between the groups postoperatively. Pre-rehabilitation sBP and dBP levels were 112.5 mmHg (104.3–120) and 68 mmHg (61.5–74), respectively, in the elderly group compared with 121.5 mmHg (110–130) and 72 mmHg (60–75), respectively, in the control group. Post-rehabilitation sBP and dBP levels were 123 mmHg (112.3–133.3) and 75 mmHg (65.5–81.3), respectively, in the elderly group compared with 121 mmHg (110–134.3) and 70 mmHg (59–80), respectively, in the control group. There were no statistical differences in pre-rehabilitation and post-rehabilitation blood pressure levels between the groups. During the rehabilitation program, antihypertensive drugs, including calcium blockers, ARB or ACE inhibitors, and beta blockers, were prescribed to control blood pressure. The ARB and ACE inhibitors were needed less significantly in patients in the elderly group to control the blood pressure (P = 0.003), although the use of calcium blockers and beta blockers was not significantly different between the groups. The combination of the aforementioned three drugs was needed less significantly in patients in the elderly group to control blood pressure (P = 0.004).
The prognostic value of patients’ ability to walk 200 m postoperatively was evaluated using ROC analysis; the results showed that AUC as a prognostic indicator for late mortality was 0.878 (95% confidence interval [CI]: 0.722–1; P = 0.002), with the highest accuracy at 30 days (sensitivity = 83.3%, specificity = 91.8%; Figure 2A). Evaluation of patient’s ability to walk 100 m postoperatively using the ROC analysis as well, the AUC as a prognostic indicator for late mortality was 0.878 (95% CI: 0.753–1; P = 0.002), with a the highest accuracy at 20 days (sensitivity = 83.3%, specificity = 82%; Figure 2B).