Article ; Online: Mortality following elective abdominal aortic aneurysm repair in women.
The British journal of surgery
2022 Volume 109, Issue 4, Page(s) 340–345
Abstract: Background: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors ... ...
| Abstract | Background: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women. Methods: Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR). Results: Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase). Conclusion: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors. |
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| MeSH term(s) | Aortic Aneurysm, Abdominal ; Blood Vessel Prosthesis Implantation/methods ; Elective Surgical Procedures/methods ; Endovascular Procedures/methods ; Female ; Hospital Mortality ; Humans ; Male ; Retrospective Studies ; Risk Factors ; Treatment Outcome |
| Language | English |
| Publishing date | 2022-03-14 |
| Publishing country | England |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2985-3 |
| ISSN | 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688 |
| ISSN (online) | 1365-2168 |
| ISSN | 0263-1202 ; 0007-1323 ; 1355-7688 |
| DOI | 10.1093/bjs/znab465 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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