Editor's Choice - Variation in Intact Abdominal Aortic Aneurysm Repair Outcomes by Country: Analysis of International Consortium of Vascular Registries 2010 - 2016.
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal
/ mortality
Elective Surgical Procedures
/ statistics & numerical data
Endovascular Procedures
/ statistics & numerical data
Female
Hospital Mortality
/ trends
Humans
Male
Middle Aged
Prospective Studies
Registries
/ statistics & numerical data
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
Abdominal aortic aneurysm
EVAR
Mortality
Registry
Surgery
Journal
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
ISSN: 1532-2165
Titre abrégé: Eur J Vasc Endovasc Surg
Pays: England
ID NLM: 9512728
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
03
08
2020
revised:
17
03
2021
accepted:
31
03
2021
pubmed:
20
6
2021
medline:
21
8
2021
entrez:
19
6
2021
Statut:
ppublish
Résumé
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. Prospective data on primary repair of intact AAA were collected from 11 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. 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. 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.
Identifiants
pubmed: 34144883
pii: S1078-5884(21)00295-1
doi: 10.1016/j.ejvs.2021.03.034
pii:
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
16-24Subventions
Organisme : FDA HHS
ID : U01 FD006936
Pays : United States
Organisme : FDA HHS
ID : U01 FD005478
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2021 European Society for Vascular Surgery. All rights reserved.