Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms

Kara, İbrahim; Sacli, Hakan

doi:10.31832/smj.645571

Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms

Hakan Saçlı, (Sakarya Üniversitesi, Tıp Fakültesi, Kalp Damar Cerrahisi Anabilim Dalı, Sakarya, Türkiye)

İbrahim Kara (Sakarya Üniversitesi, Tıp Fakültesi, Kalp Damar Cerrahisi Anabilim Dalı, Sakarya, Türkiye)

Sakarya Tıp Dergisi

1 0

Yıl: 2020 Cilt: 10 Sayı: 1 Sayfa Aralığı: 65 - 73 Metin Dili: İngilizce DOI: 10.31832/smj.645571 İndeks Tarihi: 23-05-2021

Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms

Öz:

Objective Endovascular aortic repair (EVAR) has been preferred increasingly surgical repair for abdominal aortic aneurysms (AAAs). This minimally invasive procedure has favorable effects in the earlyperiod but our purpose is to reveal the anatomical and non-anatomical risk factors affecting mortality and morbidity after EVAR in the prolonged period.Materialsand MethodsA total of 96 patients (91 male, 5 female) electively EVAR operated for infrarenal AAAs between September 2014 to January 2019 is included to the study. Preoperative and postoperativecomputed tomography (CT) scans is controlled periodically and determined individually. Demographic factors, anatomical properties of the AAAs and non-anatomical risk factors areassessed. Kaplan-Meier survival analysis was used to determine survival rates. Cox regression and hazard ratio (HR) was used to assess the relation of these determined factors on mortalityand morbidity.Results Mean follow up time was 27,45 ± 12,99 months. We found that aortic neck morphology has an statistically significant effect on mortality (p value: 0.046 and HR: 1,73 [1,01-2,96]). Aorticneck angle, cigarette smoking, obesity, peripheral artery disease (PAD), coronary artery disease, chronic obstructive pulmonary disease have an increased hazard ratio on mortality (HR inorder; 1,39; 1,45; 3,33; 1,84; 1,87; 3,60). Increased creatinine level (p value: 0.003), presence of chronic renal failure (p value: 0.013) and diabetes mellitus (p value: 0.038) have an statisticallysignificant negative effect on morbidity. Obesity and PAD have an increased hazard ratio on morbidity (HR in order; 4,58; 1,61).Conclusion This study showed us survival after EVAR procedure is connected with several pre and postoperative factors. Preoperative detailed evaluation for the anatomical properties of aneurysm isimportant to achieve prolonged benefit and postoperative follow up is crucial.

Anahtar Kelime:

Abdominal Aort Anevrizmalarına Yönelik Uygulanan Endovasküler Aort Tamiri Sonrası Mortalite ve Morbiditeye Etki Eden Faktörler

Öz:

Amaç Endovasküler aort tamiri (EVAT) abdominal aort anevrizmalarında artan bir oranda cerrahi seçenek olarak uygulanmaktadır. Minimal invazif bir prosedür olan EVAT işlemi sonrası mortalite ve morbiditeye etki eden faktörleri araştırdık. Gereç ve Yöntemler Eylül 2014 ile Ocak 2019 yılları arasında toplam 96 (91 erkek, 5 kadın) elektif EVAT uygulanmış hastalar çalışmaya dahil edildi. Ameliyat öncesi ve sonrası bilgisayarlı tomografi görüntüleri incelendi ve rutin kontroller ile takip edildi. Demografik faktörler, anevrizmanın anatomik özellikleri ve diğer risk faktörleri incelendi. Kaplan-Meier sağkalım analizi yapıldı. Cox regresyon analizi ile risk faktörlerinin mortalite ve morbiditedeki artış riski hesaplandı ve HR (hazard ratio) olarak değer belirtildi. Bulgular Ortalama takip süresi 27,45 ± 12,99 aydı. Aort boyun morfolojisin istatistiksel anlamlı olarak mortalite üzerine etkili olduğu görüldü (p değeri:0.046). Aort boyun açısı, sigara, perifer arter hastalığı (PAH), koroner arter hastalığı, kronik obstrüktif akciğer hastalığının bulunmasıyla mortalite üzerinde zarar görme riskinin yükseldiği görüldü (HR sırasıyla: 1,39; 1,45; 3,33; 1,84; 1,87; 3,60). Artmış kreatinin seviyesi (p değeri:0.003), kronik böbrek yetmezliği (p değeri:0.013), şeker hastalığı (p değeri: 0.038)’nın morbidite üzerinde istatistiksel olarak anlamlı olumsuz etkisi olduğu görüldü. Obezite ve PAH’nın morbidite üzerine zarar verme riskinin arttığı görüldü (HR sırasıyla: 4,58; 1,61). Sonuç Bu çalışma bize hayatta kalımın ve morbiditenin EVAT sonrası, ameliyat öncesi ve sonrası faktörlerden etkilendiğini gösterdi. EVAT işlemi öncesi anevrizmanın anatomik özelliklerinin ayrıntılı değerlendirilmesi, işlemden en iyi oranda fayda görülmesi açısından önemlidir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Sacli H, Kara İ (2020). Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. , 65 - 73. 10.31832/smj.645571
Chicago	Sacli Hakan,Kara İbrahim Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. (2020): 65 - 73. 10.31832/smj.645571
MLA	Sacli Hakan,Kara İbrahim Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. , 2020, ss.65 - 73. 10.31832/smj.645571
AMA	Sacli H,Kara İ Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. . 2020; 65 - 73. 10.31832/smj.645571
Vancouver	Sacli H,Kara İ Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. . 2020; 65 - 73. 10.31832/smj.645571
IEEE	Sacli H,Kara İ "Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms." , ss.65 - 73, 2020. 10.31832/smj.645571
ISNAD	Sacli, Hakan - Kara, İbrahim. "Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms". (2020), 65-73. https://doi.org/10.31832/smj.645571

APA	Sacli H, Kara İ (2020). Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. Sakarya Tıp Dergisi, 10(1), 65 - 73. 10.31832/smj.645571
Chicago	Sacli Hakan,Kara İbrahim Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. Sakarya Tıp Dergisi 10, no.1 (2020): 65 - 73. 10.31832/smj.645571
MLA	Sacli Hakan,Kara İbrahim Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. Sakarya Tıp Dergisi, vol.10, no.1, 2020, ss.65 - 73. 10.31832/smj.645571
AMA	Sacli H,Kara İ Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. Sakarya Tıp Dergisi. 2020; 10(1): 65 - 73. 10.31832/smj.645571
Vancouver	Sacli H,Kara İ Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms. Sakarya Tıp Dergisi. 2020; 10(1): 65 - 73. 10.31832/smj.645571
IEEE	Sacli H,Kara İ "Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms." Sakarya Tıp Dergisi, 10, ss.65 - 73, 2020. 10.31832/smj.645571
ISNAD	Sacli, Hakan - Kara, İbrahim. "Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms". Sakarya Tıp Dergisi 10/1 (2020), 65-73. https://doi.org/10.31832/smj.645571