Long-term outcomes and factors influencing late survival following elective abdominal aortic aneurysm repair: a 24-year experience

Khashram, Manar, Jenkins, Julie S., Jenkins, Jason, Kruger, Allan J., Boyne, Nicholas S., Foster, Wallace and Walker, Philip J. (2016) Long-term outcomes and factors influencing late survival following elective abdominal aortic aneurysm repair: a 24-year experience. Vascular, 24 2: 115-125. doi:10.1177/1708538115586682


Author Khashram, Manar
Jenkins, Julie S.
Jenkins, Jason
Kruger, Allan J.
Boyne, Nicholas S.
Foster, Wallace
Walker, Philip J.
Title Long-term outcomes and factors influencing late survival following elective abdominal aortic aneurysm repair: a 24-year experience
Journal name Vascular   Check publisher's open access policy
ISSN 1708-539X
1708-5381
Publication date 2016-04-01
Year available 2015
Sub-type Article (original research)
DOI 10.1177/1708538115586682
Open Access Status Not Open Access
Volume 24
Issue 2
Start page 115
End page 125
Total pages 11
Place of publication London, United Kingdom
Publisher SAGE Publications
Collection year 2017
Language eng
Formatted abstract
Background: Abdominal aortic aneurysms can be either treated by an open abdominal aortic aneurysm repair or an endovascular repair. Comparing clinical predictors of outcomes and those which influence survival rates in the long term is important in determining the choice of treatment offered and the decision-making process with patients.

Aims: To determine the influence of pre-existing clinical predictors and perioperative determinants on late survival of elective open abdominal aortic aneurysm repair and endovascular repair at a tertiary hospital.

Methods: Consecutive patients undergoing elective abdominal aortic aneurysm repair from 1990 to 2013 were included. Data were collected from a prospectively acquired database and death data were gathered from the Queensland state death registry. Pre-existing risks and perioperative factors were assessed independently. Kaplan–Meier and Cox regression modeling were performed.

Results: During the study period, 1340 abdominal aortic aneurysms were repaired electively, of which 982 were open abdominal aortic aneurysm repair. The average age was 72.4 years old and 81.7% were males. The cumulative percentage survival rates for open abdominal aortic aneurysms repair at 5, 10, 15 and 20 years were 79, 49, 31 and 22, respectively. The corresponding 5-, 10- and 15-year survival rates for endovascular repair were not significantly different at 75, 49 and 33%, respectively (P = 0.75). Predictors of reduced survival were advanced age, American Society of Anaesthesiology scores, chronic obstructive pulmonary disease, renal impairment, bifurcated grafts, peripheral vascular disease and congestive heart failure.

Conclusions: Open repair offers a good long-term treatment option for patients with an abdominal aortic aneurysm and in our experience there is no significant difference in late survival between open abdominal aortic aneurysms repair and endovascular repair. Consideration of the factors identified in this study that predict reduced long-term survival for open abdominal aortic aneurysms repair and endovascular repair should be considered when deciding repair of abdominal aortic aneurysm.
Keyword Abdominal aortic aneurysm repair
EVAR
Model
Open aortic repair
Risk factors
Survival
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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