The Long-Term Survival Rates of Patients After Repair of Abdominal Aortic Aneurysms

Abstract

This study was undertaken to examine the long-term survival rates of patients following abdominal aortic aneurysm (AAA) repair in comparison with an age-matched normal population, and to determine by multivariate analysis the factors influencing long-term survival. Of 125 patients who underwent AAA repair prior to July 1986, 13 died during hospitalization. Of these 13 patients, 6 who suffered aneurysmal rupture all died within 30 days. The survival rate of patients with ruptured aortic aneurysms was significantly lower than that of those with nonruptured aneurysms. Of the 112 patients surviving hospitalization, 85 died within 0.48 to 24 years after their operation. The long-term survival rate of patients who had suffered a preoperative cardiovascular event was significantly lower than that of those who had not suffered a preoperative cardiovascular event. The actual survival rate was significantly lower than the expected survival rate. According to a multivariate analysis, the significant predictors of late survival were age, aneurysmal rupture, and chronic renal failure in all the patients, and age, chronic renal failure, and pre- and postoperative cardiovascular events in patients who did not die in hospital. These findings indicate the importance of improving immediate perioperative management of ruptured AAA and that cardiovascular events should be prevented, or treated during long-term follow-up.

Systematic Review and Meta-analysis of Factors Influencing Survival Following Abdominal Aortic Aneurysm Repair

“…1). Six studies were included in the systematic review but were excluded from the meta-analysis as their data were descriptive without any reported hazard risk ratios, 9e 11 ambiguous without any variables defined, 12 or they included factors not relevant to this review. 13,14 In all, 21 authors were contacted and 11 provided information regarding the data or the study.…”

Carotid ultrasound findings as a predictor of long-term survival after abdominal aortic aneurysm repair: a 14-year prospective study

“…Age, CAD, hypertension, chronic renal failure and previous history of cerebrovascular events are among the most commonly cited factors related to long-term survival after elective AAA repair. [20][21][22][23][24][25][26][27] However, there is unanimity only regarding the predictive value of age, and no consensus regarding the prognostic value of other major risk factors, including hypertension and even CAD. [21][22][23][24] The inability of several studies to determine the negative influence of well-established atherosclerotic risk factors on survival has been attributed to many reasons, such as small number of patients, short follow-up, or inadequate preoperative detection of CAD.…”

“…[20][21][22][23][24][25][26][27] However, there is unanimity only regarding the predictive value of age, and no consensus regarding the prognostic value of other major risk factors, including hypertension and even CAD. [21][22][23][24] The inability of several studies to determine the negative influence of well-established atherosclerotic risk factors on survival has been attributed to many reasons, such as small number of patients, short follow-up, or inadequate preoperative detection of CAD. 22 Apart from these possible explanations, we believe that the inclusion of deaths not related to complications of atherosclerosis in the outcome measures reduces the ability of a study to detect the deleterious effect of atherosclerotic risk factors.…”

In-hospital mortality from abdominal aortic surgery in Great Britain and Ireland: Vascular Anaesthesia Society audit

“…The studies suggest a mortality rate for elective infrarenal aortic surgery of between 4 and 7 per cent 6±14 , which may not have changed in 20 years 8 . Factors associated with an increased mortality rate include increasing age 8,11,15 , chronic renal impairment 13,15,16 , hypertension 13 and surgery in centres that perform few aortic operations 7,14 .…”