The effect of recent chemotherapy in aorto-iliac aneurysm repair
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The effect of recent chemotherapy in aorto-iliac aneurysm repair. / Tsilimparis, Nikolaos; Ricotta, Joseph J; Dayama, Anand; Reeves, James G; Perez, Sebastian; Sweeney, John F.
In: VASCULAR, Vol. 22, No. 2, 04.2014, p. 98-104.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The effect of recent chemotherapy in aorto-iliac aneurysm repair
AU - Tsilimparis, Nikolaos
AU - Ricotta, Joseph J
AU - Dayama, Anand
AU - Reeves, James G
AU - Perez, Sebastian
AU - Sweeney, John F
PY - 2014/4
Y1 - 2014/4
N2 - The aim of the study was to investigate the effect of recent chemotherapy (Chx) on outcome of aorto-iliac aneurysm (AAA) repair. The 2005-2010 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to identify vascular patients undergoing AAA repair within 30 days after Chx. Seventy-one patients underwent AAA repair within 30 days of receiving Chx, group A (71 ± 8.4 years, 77.5% males) and 20,024 patients underwent AAA repair without prior Chx, group B (73 ± 9 years, 79.2% males). The two groups did not significantly differ with respect to open or endovascular repair (open repair A: 32%, B: 35%, P = 0.66). However, patients in group A presented more often as emergent cases (A: 27%, B: 12%, P = 0.001). Multivariable regression analysis for emergent cases after adjustment for relevant confounders also demonstrated that patients with recent Chx present more often as emergency (P = 0.001, odds ratio [OR]: 2.4). Thirty-day non-surgical complications were more common in group A (A: 25%, B: 16.5%, P = 0.046) while surgical complications were equivalent (A: 15.5%, B: 12.3%, P = 0.414). Risk of death was significantly higher in group A in univariate analysis (A: 13%, B: 5%, P = 0.005, OR: 2.6). Patients who receive Chx within 30 days prior to AAA repair present more frequently as emergencies leading to higher mortality. The reason for this cannot be sufficiently explained by the current database but patient selection for elective repair or the effect of Chx on the natural course of AAA may play a role.
AB - The aim of the study was to investigate the effect of recent chemotherapy (Chx) on outcome of aorto-iliac aneurysm (AAA) repair. The 2005-2010 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to identify vascular patients undergoing AAA repair within 30 days after Chx. Seventy-one patients underwent AAA repair within 30 days of receiving Chx, group A (71 ± 8.4 years, 77.5% males) and 20,024 patients underwent AAA repair without prior Chx, group B (73 ± 9 years, 79.2% males). The two groups did not significantly differ with respect to open or endovascular repair (open repair A: 32%, B: 35%, P = 0.66). However, patients in group A presented more often as emergent cases (A: 27%, B: 12%, P = 0.001). Multivariable regression analysis for emergent cases after adjustment for relevant confounders also demonstrated that patients with recent Chx present more often as emergency (P = 0.001, odds ratio [OR]: 2.4). Thirty-day non-surgical complications were more common in group A (A: 25%, B: 16.5%, P = 0.046) while surgical complications were equivalent (A: 15.5%, B: 12.3%, P = 0.414). Risk of death was significantly higher in group A in univariate analysis (A: 13%, B: 5%, P = 0.005, OR: 2.6). Patients who receive Chx within 30 days prior to AAA repair present more frequently as emergencies leading to higher mortality. The reason for this cannot be sufficiently explained by the current database but patient selection for elective repair or the effect of Chx on the natural course of AAA may play a role.
KW - Aged
KW - Antineoplastic Agents/adverse effects
KW - Aortic Aneurysm, Abdominal/mortality
KW - Aortic Rupture/surgery
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Chi-Square Distribution
KW - Elective Surgical Procedures
KW - Emergencies
KW - Endovascular Procedures/adverse effects
KW - Female
KW - Humans
KW - Iliac Aneurysm/mortality
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Odds Ratio
KW - Patient Selection
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1177/1708538112473970
DO - 10.1177/1708538112473970
M3 - SCORING: Journal article
C2 - 23512896
VL - 22
SP - 98
EP - 104
JO - VASCULAR
JF - VASCULAR
SN - 1708-5381
IS - 2
ER -