scholarly journals Survival following abdominal aortic aneurysm repair in North Queensland is not associated with remoteness of place of residence

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241802
Author(s):  
Jonathan Golledge ◽  
Aaron Drovandi ◽  
Ramesh Velu ◽  
Frank Quigley ◽  
Joseph Moxon
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Hazard Analysis ◽  
Abdominal Aortic Aneurysm Repair ◽  
Place Of Residence ◽  
Clinical Events ◽  
Abdominal Aortic ◽  
Elective Repair ◽  
Aneurysm Repair ◽  
Related Mortality

Objective To assess whether survival and clinical events following elective abdominal aortic aneurysm (AAA) repair were associated with remoteness of residence in North Queensland, Australia. Methods This retrospective cohort study included participants undergoing elective AAA repair between February 2002 and April 2020 at two hospitals in Townsville, North Queensland, Australia. Outcomes were all-cause survival and AAA-related events, defined as requirement for repeat AAA repair or AAA-related mortality. Remoteness of participant’s place of residence was assessed by the Modified Monash Model classifications and estimated distance from the participants’ home to the tertiary vascular centre. Cox proportional hazard analysis examined the association of remoteness with outcome. Results The study included 526 participants undergoing elective repair by open (n = 204) or endovascular (n = 322) surgery. Fifty-four (10.2%) participants had a place of residence at a remote or very remote location. Participants' were followed for a median of 5.2 (inter-quartile range 2.5–8.3) years, during which time there were 252 (47.9%) deaths. Survival was not associated with either measure of remoteness. Fifty (9.5%) participants had at least one AAA-related event, including 30 (5.7%) that underwent at least one repeat AAA surgery and 23 (4.4%) that had AAA-related mortality. AAA-related events were more common in participants resident in the most remote areas (adjusted hazard ratio 2.83, 95% confidence intervals 1.40, 5.70) but not associated with distance from the participants’ residence to the tertiary vascular centre Conclusions The current study found that participants living in more remote locations were more likely to have AAA-related events but had no increased mortality following AAA surgery. The findings emphasize the need for careful follow-up after AAA surgery. Further studies are needed to examine the generalisability of the findings.

Development of a scoring system to estimate mortality in abdominal aortic aneurysms management

Vascular ◽  
2014 ◽  
Vol 23 (6) ◽  
pp. 586-591 ◽  
Author(s):  
Anahita Dua ◽  
Mohammed M Algodi ◽  
Courtney Furlough ◽  
Hunter Ray ◽  
Sapan S Desai
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Nationwide Inpatient Sample ◽  
Abdominal Aortic Aneurysm Repair ◽  
Inpatient Mortality ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Elective Repair ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Introduction This study aimed to define risk factors associated with inpatient mortality in patients undergoing elective repair for unruptured abdominal aortic aneurysm and utilize these factors to create a scoring system to estimate risk of mortality. Methods A retrospective analysis was completed using the Nationwide Inpatient Sample from 1998 to 2011. Patients who underwent elective abdominal aortic aneurysm repair were identified using ICD-9 codes. Demographics, comorbidities, length of stay, insurance status, and mortality were recorded. Statistically significant variables were identified using a multivariate analysis, and a discriminant analysis was used to identify factors predictive of inpatient mortality. Results Over a 14-year period, 28,448 patients underwent elective repair of an unruptured abdominal aortic aneurysm. Independent variables associated with inpatient mortality included: age >60, female gender, congestive heart failure, peripheral artery disease, renal failure, malnutrition, and hypercoagulability. Endovascular aneurysm repair was protective against inpatient mortality. The area under the curve for the discriminant function was 0.83 (95% CI, 0.81–0.85) and successfully classified 87.9% of patients within the Nationwide Inpatient Sample (25,006/28,448 patients). Conclusion Seven factors that predict an increased risk of mortality and one factor that decreased the risk of mortality were identified. Preoperative risk factor mitigation may improve mortality following elective abdominal aortic aneurysm repair.

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