TY - JOUR
T1 - Predictors of 1-Year Survival after Endovascular Aneurysm Repair
AU - Fitridge, Robert A.
AU - Boult, Margaret
AU - De Loryn, Tania
AU - Cowled, Prudence A.
AU - Barnes, Mary B.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Objective/background The purpose of this study was to determine the preoperative variables that best predict 1-year survival following elective endovascular aneurysm repair (EVAR), a period of time that would suggest the patient had benefited from the procedure. Most EVAR survival studies focus on early and late survival; scant information is available for 1-year survival. Methods Data from two Australian audits of EVAR (1999-2001 and 2009-13) were combined (n = 1,647). Preoperative variables included routine demographic data, clinical health assessments, computed tomography-derived anatomical data, and all-cause mortality. Univariate and multivariate logistic regressions determined which variables best predicted 1-year survival. Results One-year survival after EVAR was 93.7% (1,544/1,647) and 30-day survival was 98.4% (1,620/1,647). Univariate analyses found that nine preoperative variables were significantly associated with 1-year survival. Five variables were included in the final multivariate model: American Society of Anesthesiologists physical status, aneurysm diameter, creatinine, respiratory assessment, and severity of iliac artery calcification (receiver-operator curve 0.717, R2 =.117). Predicted 1-year survival ranged from 98.6% to 68.0%, based on differences in aneurysm size and patient comorbidities. Conclusion Personalised 1-year survival risk enables surgeons and patients to consider seriously the risks and benefits of EVAR prior to surgery.
AB - Objective/background The purpose of this study was to determine the preoperative variables that best predict 1-year survival following elective endovascular aneurysm repair (EVAR), a period of time that would suggest the patient had benefited from the procedure. Most EVAR survival studies focus on early and late survival; scant information is available for 1-year survival. Methods Data from two Australian audits of EVAR (1999-2001 and 2009-13) were combined (n = 1,647). Preoperative variables included routine demographic data, clinical health assessments, computed tomography-derived anatomical data, and all-cause mortality. Univariate and multivariate logistic regressions determined which variables best predicted 1-year survival. Results One-year survival after EVAR was 93.7% (1,544/1,647) and 30-day survival was 98.4% (1,620/1,647). Univariate analyses found that nine preoperative variables were significantly associated with 1-year survival. Five variables were included in the final multivariate model: American Society of Anesthesiologists physical status, aneurysm diameter, creatinine, respiratory assessment, and severity of iliac artery calcification (receiver-operator curve 0.717, R2 =.117). Predicted 1-year survival ranged from 98.6% to 68.0%, based on differences in aneurysm size and patient comorbidities. Conclusion Personalised 1-year survival risk enables surgeons and patients to consider seriously the risks and benefits of EVAR prior to surgery.
KW - Abdominal aortic aneurysm
KW - Mortality
KW - Endovascular procedures
UR - http://purl.org/au-research/grants/NHMRC/565335
UR - http://www.scopus.com/inward/record.url?scp=84961665168&partnerID=8YFLogxK
U2 - 10.1016/j.ejvs.2015.12.019
DO - 10.1016/j.ejvs.2015.12.019
M3 - Article
VL - 51
SP - 528
EP - 534
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
SN - 1078-5884
IS - 4
ER -