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Risk factors predicted mortality following EVAR, open surgical aneurysm repair
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Accumulating risk factors may be predictors of one-year survival following invasive surgical procedures for aneurysm repair, recent study results suggested.
A predictive risk model developed by Adam W. Beck, MD, and researchers from the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., illustrated correlations between accumulating risk factors and the potential one-year survival following endovascular abdominal aortic aneurysm repair (EVAR) or open aneurysm repair.
“Surgeons usually discuss annual rupture risk with patients and balance this against operative or 30-day mortality,” Beck said in his presentation. “To adequately judge the success of aneurysm repair, however, longer survival must be considered, and most would agree that at least one-year survival is essential for patients undergoing elective aneurysm repair independent of aneurysm diameter.”
According to Beck, the researchers analyzed 1,387 patients from the Vascular Study Group of Northern New England database, 639 of whom underwent endovascular repair and 748 of whom underwent open-aneurysm repair. Thirty-day mortality was 0.5% in the endovascular group compared with 2.3% in the open-repair group. One-year mortality was 5.7% in the endovascular group compared with 5.8% in the open repair group. A univariate analysis indicated that congestive HF and aneurysm diameter greater than 6.5 cm were independently predictive of one-year mortality. A model developed using the two risk factors predicted one-year mortality ranging from 3.6% in patients who had one of the risk factors to 23% in patients who had both risk factors.
“Predicted mortality correlated well with observed mortality rates in these patients with an observed prospective ratio of 0.96,” Beck said. “It is important to note that only 8% of deaths within one year of endovascular repair and 40% of deaths within one year of open repair occurred within the first 30 days after operation, underscoring the importance of looking past the hospital results to define successful outcome.”
For more information:
- Beck A. #SS24.