Risk factors for immediate results and long-term survival following elective open surgery for AAA.

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COD: 265-276 Categorie: ,

Stefano Bonardelli, Giovanni Parrinello, Maurizio De Lucia, Franco Nodari, Roberto Maffeis, Edoardo Cervi, Fabio Viotti, Tullio Piardi, Nazario Portolani, Stefano M. Giulini

Ann. Ital. Chir., 2007; 78: 265-276

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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.

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