Thirty-day mortality in females after elective and urgent abdominal aortic aneurysm repair
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Thirty-day mortality in females after elective and urgent abdominal aortic aneurysm repair. / Nana, Petroula; Spanos, Konstantinos; Behrendt, Christian-Alexander; Dakis, Konstantinos; Brotis, Alexandros; Kouvelos, George; Giannoukas, Athanasios; Kolbel, Tilo.
in: J CARDIOVASC SURG, Jahrgang 64, Nr. 5, 10.2023, S. 495-503.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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T1 - Thirty-day mortality in females after elective and urgent abdominal aortic aneurysm repair
AU - Nana, Petroula
AU - Spanos, Konstantinos
AU - Behrendt, Christian-Alexander
AU - Dakis, Konstantinos
AU - Brotis, Alexandros
AU - Kouvelos, George
AU - Giannoukas, Athanasios
AU - Kolbel, Tilo
PY - 2023/10
Y1 - 2023/10
N2 - INTRODUCTION: Female sex is a risk factor of post-operative mortality and morbidity after abdominal aortic aneurysm (AAA) repair. The aim of this systematic review is to assess the sex-specific early mortality following both elective and urgent AAA repair.EVIDENCE ACQUISITION: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. Observational studies (2000-2022), of the English medical literature, focusing on early mortality after AAA repair in females under elective or urgent setting were eligible. A systematic search of MEDLINE, EMBASE and CENTRAL databases, was conducted (November 30th, 2022). The risk of bias was assessed using the Newcastle-Ottawa Scale. Primary outcome was 30-day mortality in relevant strata. A proportional metanalysis was used to assess the estimates.EVIDENCE SYNTHESIS: Seventeen retrospective studies and 83,738 females were included. Thereof 68.7% underwent elective repair while the remaining were managed urgently. Endovascular repair (EVAR) was applied in 37.3% of patients (15.4% urgent) vs. 62.7% with OSR (23.5% urgent). In the total cohort, the perioperative mortality was estimated at 11% (OR, 95% CI: 5-17%, P<0.01, I2 99.92%) while 3% (OR, 95% CI: 0.02-0.03, P<0.01, I2 93.42%) deceased after elective repair (2% OR, 95% CI 0.01-0.02, P<0.01, I2 83.08%, after EVAR and 5% (OR, 95% CI: 0.05-0.06, P<0.01, I2 77.36%, after OSR) and 36% (OR, 95% CI: 0.28-0.44, P<0.01, I2 99.51%) after urgent repair (25% OR, 95% CI: 0.16-0.34, P<0.01, I2 98.45%, after EVAR and 40% (OR, 95% CI: 0.34-0.46, P<0.01, I2 95.96%, after OSR).CONCLUSIONS: AAA repair in females appears to be associated with considerable postoperative mortality. Despite the rapid development of innovative techniques and intensive care of severely ill patients, perioperative mortality after ruptured AAA remains devastatingly high.
AB - INTRODUCTION: Female sex is a risk factor of post-operative mortality and morbidity after abdominal aortic aneurysm (AAA) repair. The aim of this systematic review is to assess the sex-specific early mortality following both elective and urgent AAA repair.EVIDENCE ACQUISITION: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. Observational studies (2000-2022), of the English medical literature, focusing on early mortality after AAA repair in females under elective or urgent setting were eligible. A systematic search of MEDLINE, EMBASE and CENTRAL databases, was conducted (November 30th, 2022). The risk of bias was assessed using the Newcastle-Ottawa Scale. Primary outcome was 30-day mortality in relevant strata. A proportional metanalysis was used to assess the estimates.EVIDENCE SYNTHESIS: Seventeen retrospective studies and 83,738 females were included. Thereof 68.7% underwent elective repair while the remaining were managed urgently. Endovascular repair (EVAR) was applied in 37.3% of patients (15.4% urgent) vs. 62.7% with OSR (23.5% urgent). In the total cohort, the perioperative mortality was estimated at 11% (OR, 95% CI: 5-17%, P<0.01, I2 99.92%) while 3% (OR, 95% CI: 0.02-0.03, P<0.01, I2 93.42%) deceased after elective repair (2% OR, 95% CI 0.01-0.02, P<0.01, I2 83.08%, after EVAR and 5% (OR, 95% CI: 0.05-0.06, P<0.01, I2 77.36%, after OSR) and 36% (OR, 95% CI: 0.28-0.44, P<0.01, I2 99.51%) after urgent repair (25% OR, 95% CI: 0.16-0.34, P<0.01, I2 98.45%, after EVAR and 40% (OR, 95% CI: 0.34-0.46, P<0.01, I2 95.96%, after OSR).CONCLUSIONS: AAA repair in females appears to be associated with considerable postoperative mortality. Despite the rapid development of innovative techniques and intensive care of severely ill patients, perioperative mortality after ruptured AAA remains devastatingly high.
KW - Male
KW - Humans
KW - Female
KW - Endovascular Procedures
KW - Retrospective Studies
KW - Aortic Aneurysm, Abdominal/diagnostic imaging
KW - Risk Factors
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Elective Surgical Procedures/methods
KW - Treatment Outcome
KW - Postoperative Complications/surgery
U2 - 10.23736/S0021-9509.23.12615-2
DO - 10.23736/S0021-9509.23.12615-2
M3 - SCORING: Review article
C2 - 37162239
VL - 64
SP - 495
EP - 503
JO - J CARDIOVASC SURG
JF - J CARDIOVASC SURG
SN - 0021-9509
IS - 5
ER -