Mortality following elective abdominal aortic aneurysm repair in women
Publication year
2022Source
British Journal of Surgery, 109, 4, (2022), pp. 340-345ISSN
Publication type
Article / Letter to editor
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Organization
Surgery
Journal title
British Journal of Surgery
Volume
vol. 109
Issue
iss. 4
Page start
p. 340
Page end
p. 345
Subject
Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences; Surgery - Radboud University Medical CenterAbstract
BACKGROUND: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women. METHODS: Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR). RESULTS: Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase). CONCLUSION: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.
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- Academic publications [242524]
- Electronic publications [129515]
- Faculty of Medical Sciences [92283]
- Open Access publications [104134]
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