Associations of nutritional status and muscle size with mortality after open aortic aneurysm repair

Kodama, Akio; Takahashi, Noriko; Sugimoto, Masayuki; Niimi, Kiyoaki; Banno, Hiroshi; Komori, Kimihiro

doi:10.1016/j.jvs.2019.01.049

Cited by 16 publications

(10 citation statements)

References 35 publications

(48 reference statements)

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“…They demonstrated that controlling for the nutritional status score and skeletal muscle size were useful in identifying and optimizing the treatment of highrisk patients who will not benefit from OSR so that EVAR or no intervention can be recommended. 16 The present study has several limitations. First, our study was a non-randomized, retrospective observational study at a single institution.…”

Section: Discussionmentioning

confidence: 83%

Endovascular Aneurysm Repair Compared With Open Repair Does Not Improve Survival in Octogenarians

Banno

Sugimoto

Sato

et al. 2021

Circ J

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at our institution were reviewed. Patients aged ≥80 years were included in this study. All patients provided written informed consent for their information to be recorded in a prospective collection database and met the inclusion criteria of the present study. The indication for repair was an AAA ≥5 cm in diameter, a rapidly growing aneurysm (≥5 mm per 6 months), and a saccular aneurysm. As EVAR became reimbursable in June 2007, our principle of AAA repair has been to use EVAR, if indicated, for patients aged >75 years or patients at high risk if OSR is performed, even if they are aged <75 years. 7 In patients whose aneurysms cannot be repaired with standard EVAR (i.e., proximal neck length <10 mm or severe conical neck shape), we prefer using OSR, even in patients aged >75 years. After careful examination, if it were decided that a patient could not tolerate OSR, complex EVAR using physician-modified fenestration or the chimney technique was applied. Those who required procedures for renal arteries during EVAR were excluded from this study. In the OSR group, patients requiring both infra-and supra-renal clamps were included (because E ndovascular aneurysm repair (EVAR) is widely accepted as a less invasive surgery for abdominal aortic aneurysm (AAA) and has significantly improved short-term outcomes for patients compared with open surgical repair (OSR). 1-3 Although problems with its long-term performance have been recently reported, 4-6 in general, they should not be a major concern for elderly people who do not have a long life expectancy. In contrast, better early OSR results have been observed with improvements in the operative procedure and perioperative management. Although EVAR should be more beneficial for higher-risk or more frail patients, not every elderly person is frail; thus, it is unclear whether it would be beneficial to perform EVAR solely because a patient is older. This study aimed to compare EVAR and OSR results for elderly individuals. Methods Study PopulationPatients who underwent elective EVAR and OSR for AAA

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Section: Discussionmentioning

confidence: 83%

Endovascular Aneurysm Repair Compared With Open Repair Does Not Improve Survival in Octogenarians

Banno

Sugimoto

Sato

et al. 2021

Circ J

Self Cite

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“…Very few studies focused malnutrition in AAA patients. Kodama et al 34 evaluated malnutrition status by using CONUT score in consecutive 360 AAA patients underwent OSR and showed 43.9% of patients were under the risk of malnutrition. To the best of our knowledge, the only study evaluating malnutrition in EVAR patients is Inagaki et al 35 retrospective cohort study in which malnutrition was investigated by hypoalbuminemia.…”

Section: Discussionmentioning

confidence: 99%

“…Kodama et al. 34 evaluated malnutrition status by using CONUT score in consecutive 360 AAA patients underwent OSR and showed 43.9% of patients were under the risk of malnutrition. To the best of our knowledge, the only study evaluating malnutrition in EVAR patients is Inagaki et al.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition provides important long-term prognostic information in patients undergoing endovascular abdominal aortic aneurysm repair

et al. 2020

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Objectives Malnutrition has been shown to be associated with survival in a variety of diseases. Our aim is to evaluate the prognostic value of objective nutritional indexes indicating malnutrition, in patients underwent endovascular aortic replacement. Methods We retrospectively evaluated 149 consecutive patients who underwent technically successful endovascular aortic replacement operation between October 2010 and August 2019. Objective nutritional indexes, prognostic nutritional index, geriatric nutritional risk index and controlling nutritional status, scores were calculated using the preoperative data. Optimal cut-off values were obtained by receiver operating characteristic analysis. According to the cut-off values, we investigated the relationship between indexes and the long-term all-cause mortality. Results During mean 48.0 ± 30.3 months follow-up duration, in 47 of patients (31.5%), all-cause mortality were documented. In mortality group, prognostic nutritional index (42.8 ± 7.1 vs 51.3 ± 5.2, p < 0.001) and geriatric nutritional risk index (100.7 ± 10.1 vs 107.6 ± 9.2, p < 0.001) were significantly lower, controlling nutritional status score (2.0 (1.0–4.0) vs 1.0 (0.0–2.0), p < 0.001) was higher when compared to survivor group. Kaplan–Meier curves presented higher mortality incidence in malnutrition patients evaluated with objective nutritional indexes (Log-rang test, for all three indexes p < 0.001). Besides Cox-proportional hazard analysis showed all three nutritional indexes may be a predictive marker for all-cause mortality, prognostic nutritional index introduced more valuable data than other two indexes. Conclusions Malnutrition is associated with significant increase in postoperative long-term mortality in endovascular aortic replacement patients. Preoperatively calculated objective nutritional indexes especially prognostic nutritional index can be used as an important prognostic tool.

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“…[33][34][35] In a single site retrospective study of open AAA repairs, moderate risk of malnutrition Controlling Nutritional Status (CONUT) scores (derived from serum albumin, J o u r n a l P r e -p r o o f 10 cholesterol levels and lymphocyte count in peripheral blood) were associated with mid-term mortality and life-threatening complications. 36 If screening shows risk, nutritional assessment should be made if expertise is available, and appropriate nutritional care delivered. 37,38 Oral nutritional supplements, including those containing immunonutrients, [39][40][41] are almost always preferred to enteral or parenteral nutrition regimens.…”

Section: B Nutritional Deficiencymentioning

confidence: 99%

Perioperative care in open aortic vascular surgery: A consensus statement by the Enhanced Recovery After Surgery (ERAS) Society and Society for Vascular Surgery

McGinigle

Spangler

Pichel

et al. 2022

Journal of Vascular Surgery

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Associations of nutritional status and muscle size with mortality after open aortic aneurysm repair

Cited by 16 publications

References 35 publications

Endovascular Aneurysm Repair Compared With Open Repair Does Not Improve Survival in Octogenarians

Endovascular Aneurysm Repair Compared With Open Repair Does Not Improve Survival in Octogenarians

Malnutrition provides important long-term prognostic information in patients undergoing endovascular abdominal aortic aneurysm repair

Perioperative care in open aortic vascular surgery: A consensus statement by the Enhanced Recovery After Surgery (ERAS) Society and Society for Vascular Surgery

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