Editor's Choice - Variation in Intact Abdominal Aortic Aneurysm Repair Outcomes by Country: Analysis of International Consortium of Vascular Registries 2010-2016

被引：53

作者：

Boyle, Jonathan R. ^{[1
,2
]}

Mao, Jialin ^{[3
]}

Beck, Adam W. ^{[4
]}

Venermo, Maarit ^{[5
]}

Sedrakyan, Art ^{[3
]}

Behrendt, Christian-Alexander ^{[6
]}

Szeberin, Zoltan ^{[7
]}

Eldrup, Nikolaj ^{[8
]}

Schermerhorn, Marc ^{[9
]}

Beiles, Barry ^{[10
]}

Thomson, Ian ^{[11
]}

Cassar, Kevin ^{[12
]}

Altreuther, Martin ^{[13
]}

Debus, Sebastian ^{[6
]}

Johal, Amundeep S. ^{[14
]}

Waton, Sam ^{[14
]}

Scali, Salvatore T. ^{[15
]}

Cromwell, David A. ^{[14
]}

Mani, Kevin ^{[16
]}

机构：

[1] Cambridge Univ Hosp NHS Trust, Cambridge Vasc Unit, Hills Rd, Cambridge CB2 0QQ, England

[2] Univ Cambridge, Dept Surg, Cambridge, England

[3] Weill Cornell Med Coll, Healthcare Policy & Res, New York, NY USA

[4] Univ Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA

[5] Helsinki Univ Hosp, Dept Vasc Surg, Helsinki, Finland

[6] Univ Med Ctr Hamburg Eppendorf, Dept Vasc Med, Working Grp GermanVasc, Hamburg, Germany

[7] Semmelweis Univ, Dept Vasc Surg, Budapest, Hungary

[8] Univ Copenhagen, Rigshosp, Dept Vasc Surg, Copenhagen, Denmark

[9] Beth Israel Deaconess Med Ctr, Div Vasc Surg & Endovasc Therapy, Boston, MA 02215 USA

[10] Australasian Soc Vasc Surg, Australasian Vasc Audit, Melbourne, Vic, Australia

[11] Univ Otago, Dept Surg, Dunedin, New Zealand

[12] Univ Malta, Fac Med & Surg, Dept Surg, Msida, Malta

[13] St Olays Hosp, Dept Vasc Surg, Trondheim, Norway

[14] Royal Coll Surgeons England, Clin Effectiveness Unit, 35-43 Lincolns Inn Fields, London, England

[15] Univ Florida, Coll Med, Div Vasc Surg & Endovasc Therapy, Gainesville, FL USA

[16] Uppsala Univ, Dept Surg Sci, Uppsala, Sweden

来源：

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY | 2021年 / 62卷 / 01期

关键词：

Abdominal aortic aneurysm; EVAR; Mortality; Registry; Surgery; VALIDATION; MORTALITY; EVAR; POPULATION; GUIDELINES; SURVIVAL;

D O I：

10.1016/j.ejvs.2021.03.034

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: Outcomes for intact abdominal aortic aneurysm (AAA) repair vary over time and by healthcare system, country, and surgeon. The aim of this study was to analyse peri-operative mortality for intact AAA repair in 11 countries over time and compare outcomes by gender, age, and geographical location. Methods: Prospective data on primary repair of intact AAAwere collected from11 countries through the International Consortium of Vascular Registries (ICVR) and analysed for two time periods, 2010 - 2013 and 2014 - 2016. The primary outcome was peri-operative mortality after endovascular aneurysm repair (EVAR) and open surgical repair (OSR). Multivariable logistic regression models were used to adjust for differences in patient characteristics. Results: A total of 103 715 patients were included. The percentage of patients undergoing EVAR increased from 63.6% to 71.2% (p < .001) over the study period. This proportion varied by country from 35% in Hungary to 81% in the United States. Overall peri-operative mortality decreased from 2.1% to 1.6 % (p < .001). Mortality also declined significantly over time for both OSR 4.2% to 3.6 % (p = .002) and EVAR 1.0% to 0.7% (p = .002). Mortality was significantly higher for female than male patients (3.0% vs. 1.6% p < .001). The percentage of patients > 80 years old undergoing AAA repair remained constant at 23.6% (p = .91). Peri-operative mortality was higher for patients > 80 years than for those < 80 years old (2.7% vs. 1.6% p < .001). Forty-six per cent (n = 275) of all EVAR deaths occurred in the over 80s. Conclusion: The proportion of AAA repairs performed using EVAR has increased over time. Peri-operative mortality continues to decline for both OSR and EVAR. Outcomes however were significantly worse for both women and those aged over 80, so efforts should be focused on these patient groups to further reduce elective AAA mortality rates.

引用

页码：16 / 24

页数：9

共 33 条

[31] International Vascunet Validation of the Swedvasc Registry [J].

Venermo, M. ;

Lees, T. .

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2015, 50 (06) :802-808

[32] Editor's Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms [J].

Wanhainen, Anders ;

Verzini, Fabio ;

Van Herzeele, Isabelle ;

Allaire, Eric ;

Bown, Matthew ;

Cohnert, Tina ;

Dick, Florian ;

van Herwaarden, Joost ;

Karkos, Christos ;

Koelemay, Mark ;

Koelbel, Tilo ;

Loftus, Ian ;

Mani, Kevin ;

Melissano, Germano ;

Powell, Janet ;

Szeberin, Zoltan ;

de Borst, Gert J. ;

Chakfe, Nabil ;

Debus, Sebastian ;

Hinchliffe, Rob ;

Kakkos, Stavros ;

Koncar, Igor ;

Kolh, Philippe ;

Lindholt, Jes S. ;

de Vega, Melina ;

Vermassen, Frank ;

Bjorck, Martin ;

Cheng, Stephen ;

Dalman, Ronald ;

Davidovic, Lazar ;

Donas, Konstantinos ;

Earnshaw, Jonothan ;

Eckstein, Hans-Henning ;

Golledge, Jonathan ;

Haulon, Stephan ;

Mastracci, Tara ;

Naylor, Ross ;

Ricco, Jean-Baptiste ;

Verhagen, Hence .

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2019, 57 (01) :8-93

[33]

Waton S., 2019, NATL VASCULAR REGIST

← 1 2 3 4 →