Smoking, lung function and the prognosis of abdominal aortic aneurysm

被引：0

作者：

Greenhalgh, RM ^{[1
]}

Powell, JT ^{[1
]}

Fowkes, FGR ^{[1
]}

Forbes, JF ^{[1
]}

Ruckley, CV ^{[1
]}

Poole-Wilson, PA ^{[1
]}

Browse, N ^{[1
]}

Bulpitt, CJ ^{[1
]}

Burnand, K ^{[1
]}

Coles, EC ^{[1
]}

Fletcher, A ^{[1
]}

Blair, S ^{[1
]}

Clark, R ^{[1
]}

Devine, C ^{[1
]}

Ferguson, K ^{[1
]}

Hearn, S ^{[1
]}

Kerracher, E ^{[1
]}

Logan, S ^{[1
]}

McCabe, A ^{[1
]}

Meer-Baloch, R ^{[1
]}

Mossa, M ^{[1
]}

Rattray, A ^{[1
]}

Wilson, K ^{[1
]}

Brown, L ^{[1
]}

Franks, P ^{[1
]}

Keen, N ^{[1
]}

Rose, C ^{[1
]}

Hassaine, RM ^{[1
]}

Horrocks, M ^{[1
]}

Budd, J ^{[1
]}

Horrocks, M ^{[1
]}

Baird, RN ^{[1
]}

Lamont, P ^{[1
]}

Wilkins, DC ^{[1
]}

Ashley, S ^{[1
]}

Flowerdew, K ^{[1
]}

Baker, A ^{[1
]}

Earnshaw, J ^{[1
]}

Heather, B ^{[1
]}

Gibbons, C ^{[1
]}

Blackett, RL ^{[1
]}

Parvin, SD ^{[1
]}

Harvey, DR ^{[1
]}

Hedges, R ^{[1
]}

Finch, D ^{[1
]}

Hocken, DB ^{[1
]}

Morris, GE ^{[1
]}

Shearman, CP ^{[1
]}

Lear, P ^{[1
]}

Lewis, P ^{[1
]}

机构：

[1] Charing Cross Hosp, Imperial Coll, Dept Vasc Surg, London W6 8RP, England

来源：

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY | 2000年 / 19卷 / 06期

关键词：

aortic aneurysm; smoking; cotinine; rupture; mortality;

D O I：

暂无

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: the UK Small Aneurysm Trial was established to test the benefit of prophylactic elective surgery for small abdominal aortic aneurysms (4.0-5.5 cm in diameter) and identify prognostic risk factors, including smoking. Patients, methods and outcomes: one thousand and ninety patients (902 men and 188 women, mean age 69.3 years) were randomised to either early elective surgery or ultrasonography surveillance until the aneurysm diameter exceeded 5.5 cm, mean follow-up was 4.6 years. Baseline assessments included lung function tests and continue (a smoking marker). The principal outcome measures were all-cause mortality and aneurysm rupture. Results: during the course of the trial, aneurysm rupture was diagnosed in 25 patients and 309 patients died. Whereas self-reported smoking status was not significantly associated with survival, patients without any trace of plasma cotinine had a significantly improved long-term (6-year) survival, p = 0.02. Current smokers had a lower FEV1 than post- and never-smokers. FEV1 was the most powerful predictor of long-term (6-year) survival, the crude death rates per 100 person-years were 9.1, 6.9 and 4.6 for those with FEV1 <1.91, 1.9-2.51 and >2.51 respectively, p = 0.001. Moreover, the rupture rate was 1.9% per year for patients positive for plasma cotinine compared with 0.5% in those without trace of plasma cotinine, p = 0.004. Conclusions: self-reported smoking status underestimates the effect of continued smoking on the prognosis of patients with small abdominal aortic aneurysm. Patients with high plasma cotinine concentrations (smokers) have an increased risk of aneurysm rupture and poorer long-term survival.

引用

页码：636 / 642

页数：7

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