Outcomes after elective abdominal aortic aneurysm repair in obese versus nonobese patients

Locham, Satinderjit; Rizwan, Muhammad; Dakour-Aridi, Hanaa; Faateh, Muhammad; Nejim, Besma

doi:10.1016/j.jvs.2018.03.414

Cited by 25 publications

(15 citation statements)

References 27 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3,16 There continues to be ambiguity in this area as contradictory results have been reported demonstrating no significant difference in mortality based on BMI alone. 17,21 However, other investigations analyzing outcomes in vascular surgical procedures outside of AAA repair such as lower extremity revascularizations, cerebrovascular procedures, and amputations also show a significant relationship between BMI and mortality. [18][19][20] This study represents a large cohort of patients with rAAA across 2 academic institutions demonstrating the potential predictive value of BMI on perioperative mortality.…”

Section: Discussionmentioning

confidence: 99%

Association Between Body Mass Index and Perioperative Mortality After Repair of Ruptured Abdominal Aortic Aneurysms

Liang

Wang

DiMusto

et al. 2020

Vasc Endovascular Surg

View full text Add to dashboard Cite

Objective: The attempt to repair a ruptured abdominal aortic aneurysm carries a significant risk of perioperative mortality. The relationship between body mass index (BMI) and outcomes after repair of ruptured abdominal aortic aneurysms (AAAs) has not been well defined. We report the association of BMI with outcomes after ruptured AAA repair. Methods: Patients undergoing ruptured AAA repairs between 2008 and 2017 at 2 tertiary academic centers were included in this retrospective study. Demographics (including BMI), type of repair, length of stay, and admission mortality risk scores were gathered and analyzed using bivariate and multivariate logistic regressions. Adjusted odds ratio (AOR) was reported with 95% CIs and P values from the multivariate analysis. The primary outcome was 30-day mortality. Akaike information criterion (AIC) and c-statistics were used to assess the predictive power of models including physiologic score with or without BMI. Results: A total of 202 patients underwent repair of ruptured AAA. In bivariate relationship, increased BMI was significantly associated with 30-day mortality. With multivariate analysis, adjusting for demographics, type of procedure, and physiologic score, for each kg/m2 increase in BMI, an 8% increase in the likelihood of perioperative mortality (AOR = 1.08, 95% CI: 1.01-1.17; P = .04) was observed. Conclusion: When adjusted for admission risk score, type of procedure, and demographics, obesity was associated with increased 30-day mortality. With BMI as an additional data point, the c-statistics and AIC comparisons indicated that we would have a greater ability to preoperatively estimate mortality after ruptured AAA repair. Consideration could be made to include BMI in future mortality risk scoring systems for ruptured AAA.

show abstract

Section: Discussionmentioning

confidence: 99%

Association Between Body Mass Index and Perioperative Mortality After Repair of Ruptured Abdominal Aortic Aneurysms

Liang

Wang

DiMusto

et al. 2020

Vasc Endovascular Surg

View full text Add to dashboard Cite

show abstract

“…Obese patients are more likely to suffer from postoperative renal failure after AAA repair than non-obese patients. Three of the four studies [12][13][14] used in the meta-analysis described these results. However, one study 15 described obese patients as having a lower chance of postoperative renal failure, but this study scored low on the quality assessment analysis.…”

Section: Discussionmentioning

confidence: 92%

“…Finally, three out of the four studies 12,13,15 and the meta-analysis showed that obese patients were significantly more likely to suffer from wound infections than non-obese patients. DM is a risk factor for surgical site infections for surgery in general, but especially for cardiac surgery.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Short-term Mortality and Postoperative Complications of Abdominal Aortic Aneurysm Repair in Obese versus Non-obese Patients

Zonneveld

Snelder

et al. 2021

Journal of Obesity & Metabolic Syndrome

View full text Add to dashboard Cite

Background: Obesity is a risk factor not only for abdominal aortic aneurysm (AAA) but also for complications after vascular surgery. This study was to determine the effect of obesity on short-term mortality and post-intervention complications after AAA repair. Methods: A systematic review and meta-analysis were performed. A systematic search was performed in PubMed; the articles describing the differences in post-intervention complications after open or endovascular repair of an AAA between obese and non-obese patients were selected. The primary outcome was short-term mortality defined as in-hospital mortality or mortality within 30 days after AAA repair. The secondary outcomes were cardiac complications, pulmonary failure, renal failure, and wound infections. The meta-analysis was performed using OpenMeta. Results: Four articles were included in the meta-analysis; these articles included 35,989 patients of which 10,917 (30.3%) were obese. The meta-analysis showed no significant differences for short-term mortality (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.69-1.04). Also, no significant difference was found in pulmonary failure (OR, 1.09; 95% CI, 0.85-1.42). However, obese patients were less likely to suffer from cardiac complications (OR, 0.73; 95% CI, 0.55-0.96). Nevertheless, there was a significantly higher risk of renal failure (OR, 1.16; 95% CI, 1.05-1.30) and wound infections (OR, 1.92; 95% CI, 1.55-2.38) in obese patients. Conclusion: Obesity is not a risk factor for short-term mortality after AAA repair compared to non-obesity. Moreover, obese patients suffer less from cardiac complications than non-obese patients.

show abstract

“…Data on weight, length, and body mass index were not available, but on the other hand, obesity does not increase the odds of major adverse outcomes in patients undergoing EVAR. 37…”

Section: Discussionmentioning

confidence: 99%

Survival, cardiovascular morbidity, and reinterventions after elective endovascular aortic aneurysm repair in patients with and without diabetes: A nationwide propensity-adjusted analysis

Taimour

Avdic²,

Franzén³

et al. 2019

Vasc Med

View full text Add to dashboard Cite

Epidemiological data indicate decreased risk for development and growth of abdominal aortic aneurysm (AAA) among patients with diabetes mellitus (DM). On the other hand, DM adds to increased cardiovascular (CV) morbidity and mortality. In a nationwide observational cohort study of patients registered in the Swedish Vascular Register and the Swedish National Diabetes Register, we evaluated potential effects of DM on total mortality, CV morbidity, and the need for reintervention after elective endovascular aneurysm repair (EVAR) for AAA. We compared 748 patients with and 2630 without DM with propensity score-adjusted analysis, during a median 4.22 years of follow-up for patients with DM, and 4.05 years for those without. In adjusted analysis, diabetic patients showed higher rates of acute myocardial infarction (AMI) during follow-up (relative risk (RR) 1.44, 95% CI 1.06–1.95; p = 0.02), but lower need for reintervention (RR 0.12, CI 0.02–0.91; p = 0.04). There were no differences in total (RR 0.88, CI 0.74–1.05; p = 0.15) or CV (RR 1.58, CI 0.87–2.86; p = 0.13) mortality, or stroke (RR 0.95, CI 0.68–1.32; p = 0.75) during follow-up. In conclusion, patients with DM had higher rates of AMI and lower need for reintervention after elective EVAR than those without DM, whereas neither total nor CV mortality differed between groups. The putative protective effects of DM towards further AAA enlargement and late sac rupture may help explain the lower need for reintervention and absence of excess mortality.

show abstract

Outcomes after elective abdominal aortic aneurysm repair in obese versus nonobese patients

Cited by 25 publications

References 27 publications

Association Between Body Mass Index and Perioperative Mortality After Repair of Ruptured Abdominal Aortic Aneurysms

Association Between Body Mass Index and Perioperative Mortality After Repair of Ruptured Abdominal Aortic Aneurysms

Short-term Mortality and Postoperative Complications of Abdominal Aortic Aneurysm Repair in Obese versus Non-obese Patients

Survival, cardiovascular morbidity, and reinterventions after elective endovascular aortic aneurysm repair in patients with and without diabetes: A nationwide propensity-adjusted analysis

Contact Info

Product

Resources

About