Differences in Comorbidities Between Women and Men Treated with Elective Repair for Abdominal Aortic Aneurysms: A Systematic Review and Meta-Analysis

Tedjawirja, Victoria N.; Wit, M.C.J. de; Balm, Ron; Koelemay, M.J.W.

doi:10.1016/j.avsg.2021.03.049

Cited by 7 publications

(7 citation statements)

References 63 publications

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“…A meta-analysis with 619 068 patients who underwent elective AAA repair observed a higher 30-day mortality rate in females compared with males (mortality rate, 0.04 [95% CI, 0.04–0.05] versus 0.02 [95% CI, 0.02–0.03]) despite a lower prevalence of comorbidities. 153…”

Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

“…152 A meta-analysis with 619 068 patients who underwent elective AAA repair observed a higher 30-day mortality rate in females compared with males (mortality rate, 0.04 [95% CI, 0.04–0.05] versus 0.02 [95% CI, 0.02–0.03]) despite a lower prevalence of comorbidities. 153 Among 4638 ruptured AAA repairs from 2004 to 2018 in the Vascular Quality Initiative, there was no difference in 5-year survival for endovascular versus open repair (HR, 0.88 [95% CI, 0.69–1.11]; P =0.28) for 2004 to 2012. However, from 2013 to 2018, endovascular repair was associated with longer 5-year survival compared with open repair (HR, 0.69 [95% CI, 0.60–0.79]; P <0.001).…”

Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

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Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,108

702

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,108

702

View full text Add to dashboard Cite

show abstract

“…However, the results of this study portray equal CCI scores for men and women, with an even lower effect size of CCI scores on survival in women (Supplemental Digital Content 1, Table 4, http://links.lww.com/SLA/E782). This is supported by a meta-analysis reporting fewer baseline comorbidities for women 27 . The high CV mortality of women, which persists for a longer time after surgery, points to the involvement of CV risk factors in the excess mortality for women.…”

Section: Discussionmentioning

confidence: 79%

Persistent High Long-term Excess Mortality after Elective AAA Repair Especially in Women

et al. 2023

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Objective: The aim of this time-trend analysis is to estimate long-term excess-mortality and associated cardiovascular risk for abdominal aortic aneurysm (AAA) patients after elective repair, while addressing the changes in AAA management and patient selection over time. Summary Background Data: Despite the intensification of endovascular aneurysm repair (EVAR) and cardiovascular risk management (CVRM), Swedish population data suggest that AAA patients retain a persistently high long-term mortality after elective repair. The question is whether this reflects sub-optimal treatment, a changing patient population over time, or a national phenomenon. Methods: Nationwide time-trend analysis including 40730 patients (87% men) following elective AAA repair between 1995-2017. Three timeframes were compared, each reflecting changes in the use of EVAR and intensification of CVRM. Relative survival analyses were used to estimate disease-specific excess-mortality. Competing risk of death analysis evaluated the risk of cardiovascular versus non-cardiovascular death. Sensitivity analysis evaluated the impact of changes in patient selection over time. Results: Short-term excess-mortality significantly improved over time. Long-term excess-mortality remained high with a doubled mortality risk for women (RER 1.87 (95%CI 1.73–2.02)). Excess-mortality did not differ between age-categories. The risk of cardiovascular versus non-cardiovascular death remained similar over time, with a higher risk of cardiovascular death for women. Changes in patient population (i.e. older and more comorbid patients in the latter period) marginally impacted excess-mortality (2%). Conclusions: Despite changes in AAA care, patients retain a high long-term excess-mortality after elective repair with a persistent high cardiovascular mortality risk. In this a clear sex- but no age disparity stands out.

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“…In this regard, differential treatment is necessary during the diagnosis, planning, and execution of surgical interventions. (13)(14)(15) Similarly, contextualized knowledge by nursing professionals of the distribution of diseases with surgical outcomes according to sex, will allow for timely identification of risk factors, not only for better organization of the care they must provide, but to also lessen the impact on patients from a presurgical phase.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Degree of Dependency and Hospitalization Time of Surgical Patients

Alarcón¹,

Cieza²

2023

Invest. Educ. Enferm.

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Objective. This work sought to establish the relationship between the degree of dependency with hospitalization time of patients intervened surgically in a regional hospital of Peru. Methods. The study was analytical, cross-sectional with retrospective data collection, studying 380 patients treated in the surgical service at Regional hospital Docente in the municipality of Cajamarca (Peru). The patients’ demographic and clinical information was obtained from the daily care records in the hospital’s surgery service. The univariate description was conducted through absolute and relative frequencies and confidence intervals for proportions at 95%; for the association between the degree of dependency and hospitalization time Log Rank (Mantel-Cox) – Chi-square was applied, as well as the Kaplan-Meier survival analysis, with statistical significance of p<0.05. Results. The study had 53.4% male patients, with mean age of 35.3 years, referrals from operating room (64.7%), surgery specialty (66.6%) and the most-frequent surgical intervention was appendectomy (49.7%). Mean hospitalization time was 10 days; 88.1% of the patients had grade-II dependency. The degree of patient dependency had a significant impact on the days of post-surgery hospitalization with direct relationship between both variables (p=0.038). Conclusion. Hospitalization time is determined by the degree of dependency of patients subjected to a surgical intervention; thereby, it is fundamental to anticipate all the necessary resources for proper care management.

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Differences in Comorbidities Between Women and Men Treated with Elective Repair for Abdominal Aortic Aneurysms: A Systematic Review and Meta-Analysis

Abstract: Differences in comorbidities between women and men treated with elective repair for abdominal aortic aneurysms: a systematic review and meta-analysis,

Cited by 7 publications

References 63 publications

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Persistent High Long-term Excess Mortality after Elective AAA Repair Especially in Women

Relationship between Degree of Dependency and Hospitalization Time of Surgical Patients

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