TY - JOUR
T1 - Symptomatic abdominal aortic aneurysm repair
T2 - to wait or not to wait
AU - Ten Bosch, Jan A.
AU - Koning, Sam W.
AU - Willigendael, Edith M.
AU - van Sambeek, Marc R.H.M.
AU - Stokmans, Rutger A.
AU - Prins, Martin H.
AU - Teijink, Joep A.W.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: in patients with a symptomatic abdominal aortic aneurysm (saaa), acute intervention theoretically reduces rupture risk prior to surgery whereas delayed intervention provides surgery under optimised conditions. in the present study we evaluated differences in 30-day mortality in patients with a saaa operated within 12 hours compared to patients who received treatment after 12 hours and who were optimized for surgery. MeThods: all patients with a saaa who were treated within one week after presentation were included in the analyses. The 30-day mortality rates of patients operated within 12 hours were compared to those operated after 12 hours, adjusted for type of operation and for all potential confounders. resulTs: of the 89 included patients, 37 patients received surgery within 12 hours. in patients treated within 12 hours, 30-day mortality rate was 6 (16.2%) compared to 3 (5.8%) in patients treated after 12 hours (odds ratio 0.316; Ci 0.074-1.358). When adjusted for type of operation and other confounders, odds ratios were 0.305 (Ci 0.066-1.405) and 0.270 (Ci 0.015-4.836), respectively. ConClusions: in a substantial amount of patients with an alleged symptomatic aaa, delayed surgery with patient optimisation might be justifed. However, specifc criteria in order to select patients that might beneft from delayed surgery need further investigation.
AB - Background: in patients with a symptomatic abdominal aortic aneurysm (saaa), acute intervention theoretically reduces rupture risk prior to surgery whereas delayed intervention provides surgery under optimised conditions. in the present study we evaluated differences in 30-day mortality in patients with a saaa operated within 12 hours compared to patients who received treatment after 12 hours and who were optimized for surgery. MeThods: all patients with a saaa who were treated within one week after presentation were included in the analyses. The 30-day mortality rates of patients operated within 12 hours were compared to those operated after 12 hours, adjusted for type of operation and for all potential confounders. resulTs: of the 89 included patients, 37 patients received surgery within 12 hours. in patients treated within 12 hours, 30-day mortality rate was 6 (16.2%) compared to 3 (5.8%) in patients treated after 12 hours (odds ratio 0.316; Ci 0.074-1.358). When adjusted for type of operation and other confounders, odds ratios were 0.305 (Ci 0.066-1.405) and 0.270 (Ci 0.015-4.836), respectively. ConClusions: in a substantial amount of patients with an alleged symptomatic aaa, delayed surgery with patient optimisation might be justifed. However, specifc criteria in order to select patients that might beneft from delayed surgery need further investigation.
KW - Aortic aneurysm, abdominal
KW - Disease management
KW - Operative time
KW - Surgical procedures, operative
UR - http://www.scopus.com/inward/record.url?scp=84995487672&partnerID=8YFLogxK
M3 - Article
C2 - 23867861
AN - SCOPUS:84995487672
VL - 57
SP - 830
EP - 838
JO - Journal of Cardiovascular Surgery
JF - Journal of Cardiovascular Surgery
SN - 0021-9509
IS - 6
ER -