Risk factors for immediate results and long-term survival following elective open surgery for AAA. Statistical analysis of 1111 consecutive-treated patients
Stefano Bonardelli 1, Giovanni Parrinello 2, Maurizio De Lucia 3, Franco Nodari 3, Roberto Maffeis 3, Edoardo Cervi 3, Fabio Viotti 3, Tullio Piardi 3, Nazario Portolani 4, Stefano M. Giulini 3
Affiliations
Article Info
1 Vascular Surgery; Department of Medical and Surgical Sciences
2 Medical Statistics Unit (Prof. B.M. Cesana), Department of Medical and Surgical Sciences
3 Clinical Surgery, Department of Medical and Surgical Sciences
4 Emergency Surgery, University of Brescia, Italy, Department of Medical and Surgical Sciences
Abstract
AIM OF THE STUDY: Perioperative and 10 years follow-up risk factors for 1111 consecutive open AAA repairs were statistically analyzed (χ2-test and Log-rank test methods for univariate analysis, and logistic regression model and Cox proportional-hazard model for multivariate analysis). Overall operative mortality rate was 2.7%, and significant risk factors were: 1) univariate analysis: Age (>70 years 3.9% vs 1.5% <70 years); CAD (4.3% vs 1.9% without CAD); PAD (4.7% vs 2.0%); III-IV ASA classes (3.8% vs 0% in I-II ASA classes); 2) multivariate analysis: only ASA classes. RESULTS: Long-term survival (42.3 ± 32.6 months) was 93% and 88% at 3 and 5 years respectively, with 0.2% graftrelated deaths, and significant risk factors were 1) univariate analysis: Age (92% and 84% at 3 and 5 years in patients aged >70 vs 94% and 91% <70 years); ASA classes (91% and 87% at 3 and 5 years in ASA III-IV vs 98% and 92% in ASA I-II); CAD (92% and dell’85% vs 94% and 90% without CAD); COPD (90% and 80% vs 95% and 92% without COPD); CRF (90% and 82%, vs 94% and 89% without CRF); suprarenal aortic cross-clamping for pararenal aneurysms (91% and 77% in pararenal AAA, vs 94 % and 90% in infrarenal AAA; 2) multivariate analysis: Age; ASA classes; pararenal aneurysms. There was a close relation between number (0-5) of risk factors in each patient and early and late complications. These data are very satisfactory overall, and even in high risk patients who are routinely considered for EVAR.
Keywords
- Aortic aneurysms
- EVAR
- Long-term survival
- Open surgery
- Vascular graft
