Outcomes in Octogenarians and the Effect of Comorbidities After Intact Abdominal Aortic Aneurysm Repair in the Netherlands: A Nationwide Cohort Study

作者：Anna J. Alberga, Eleonora G. Karthaus, Erik W. van Zwet, Jorg L. de Bruin, Joost A. van Herwaarden, Jan J. Wever, Hence J.M. Verhagen, P.J. Van den Akker, G.J. Akkersdijk, G.P. Akkersdijk, W.L. Akkersdijk, M.G. van Andringa de Kempenaer, C.H. Arts, J.A. Avontuur, Olaf J. Bakker, Ron Balm, W.B. Barendregt, Joost A. Bekken, M.H. Bender, B.L. Bendermacher, M. van den Berg, P. Berger, R.J. Beuk, J.D. Blankensteijn, R.J. Bleker, Joris J. Blok, A.S. Bode, M.E. Bodegom, K.E. van der Bogt, A.P.M. Boll, M.H. Booster, B.L. Borger van der Burg, Gert J. de Borst, W.T. Bos-van Rossum, Hans Bosma, J.M. Botman, L.H. Bouwman, V. Brehm, M.T. de Bruijn, J.L. de Bruin, P. Brummel, J.P. van Brussel, S.E. Buijk, Manon Buijs, M.G. Buimer, D.H. Burger, H.C.J.L. Buscher, E. Cancrinus, P.H. Castenmiller, G. Cazander, Ariane Coester, P.H. Cuypers, J. H. C. Daemen, I. Dawson, J.E. Dierikx, Martijn Dijkstra, J. Diks, M.K. Dinkelman, M. Dirven, D.E. Dolmans, R.C. van Doorn, L.M. van Dortmont, J.W. Drouven, M.M. van der Eb, D. Eefting, G.J. van Eijck, J.W. Elshof, B.H. Elsman, A. van der Elst, M.I. van Engeland, R.G. van Eps, M.J. Faber, W.M. de Fijter, Bram Fioole, Tryntsje Fokkema, F.A. Frans, W.M. Fritschy, Pingping Jin, R.H. Geelkerken, W.B. van Gent, G.J. Glade, B. Govaert, R.P. Groenendijk, H.G. de Groot, R.F. van den Haak, E.F. de Haan, G.F. Hajer, J.F. Hamming, E.S. van Hattum, Constantijn E.V.B. Hazenberg, P.P. Hedeman Joosten, Jozien Helleman, L.G. van der Hem, Jeroen Hendriks, Joost A. van Herwaarden, Jan M.M. Heyligers, Jan-Willem Hinnen, R.J. Hissink, Gwan H. Ho, P.T. den Hoed, M.T. Hoedt, F. van Hoek, Rigo Hoencamp, Werner H. Hoffmann, Wouter Hogendoorn, Arjan W.J. Hoksbergen, E.J. Hollander, M. Hommes, Cornelis J. Hopmans, L.C. Huisman, R.G. Hulsebos, K.M. Huntjens, Mirza M. Idu, M.J. Jacobs, M.F. van der Jagt, J.R. Jansbeken, Roel Janssen, H.H. Jiang, S.C. de Jong, T.A. Jongbloed-Winkel, Vincent Jongkind, M.R. Kapma, B.P. Keller, A. Khodadade Jahrome, J.K. Kievit, Peter Klemm, P. Klinkert, N.A. Koedam, M.J. Koelemaij, J.L. Kolkert, G.G. Koning, Olivier H.J. Koning, R. Konings, A.G. Krasznai, R.M. Krol, R.H. Kropman, R.R. Kruse, L. van der Laan, Maarten J. van der Laan, J.H. van Laanen, Guus W. van Lammeren, D.A. Lamprou, J.H. Lardenoye, G.J. Lauret, B.J. Leenders, D.A. Legemate, V.J. Leijdekkers, M.S. Lemson, M.M. Lensvelt, M.A. Lijkwan, Robert Lind, Fabian Linden, P.F. Liqui Lung, Maarten Loos, M.C. Loubert, Koen M. van de Luijtgaarden, Dalia Mahmoud, C.G. Manshanden, E.C. Mattens, R. Meerwaldt, Barend Mees, G.C. von Meijenfeldt, T.P. Menting, R. Metz, Robert C. Minnee, J.C. de Mol van Otterloo, M.J. Molegraaf, Y.C. Montauban van Swijndregt, Monika Morak, R.H. van de Mortel, W. Mulder, S.K. Nagesser, C.C. Naves, J.H. Nederhoed, A.M. Nevenzel-Putters, Anliu Nie, D.H. Nieuwenhuis, J. Nieuwenhuizen, R.C. van Nieuwenhuizen, D. Nio, V.J. Noyez, A.P. Oomen, B.I. Oranen, J. Oskam, H.W. Palamba, A.G. Peppelenbosch, A.S. van Petersen, Bart‐Jeroen Petri, M.E. Pierie, Alex Ploeg, Robert A. Pol, E.D. Ponfoort, Ivo C.J.H. Post, P.P. Poyck, A. Prent, Sander Ten Raa, J.T. Raymakers, M. Reichart, B.L. Reichmann, M.M. Reijnen, J.A. de Ridder, A. Rijbroek, Marie Josee van Rijn, R.A. de Roo, Ellen V. Rouwet, Ben R. Saleem, Pieter B. Salemans, M.R. van Sambeek, M.G. Samyn, H.P. van ’t Sant, Jan van Schaik, P.M. van Schaik, D.M. Scharn, Marc R. Scheltinga, Abbey Schepers, P.M. Schlejen, F.J.V. Schlösser, F.P. Schol, Vincent P.W. Scholtes, Olaf Schouten, Michiel A. Schreve, Geert Willem H. Schurink, C.J. Sikkink, A. te Slaa, H.J. Smeets, L. Smeets, R.R. Smeets, Anne Marie G. A. de Smet, P.C. Smit, T.M. Smits, Maarten G. Snoeijs, A.O. Sondakh, M.J. Speijers, T.J. van der Steenhoven, S.M. van Sterkenburg, D.A. Stigter, R.A. Stokmans, R.P. Strating, G.N. Stultiëns, J.E. Sybrandy, Joep A.W. Teijink, B.J. Telgenkamp, Martin Teraa, M.J. Testroote, T. Tha‐In, R.M. The, W.J. Thijsse, Irene Thomassen, I.F. Tielliu, R.B. van Tongeren, Raechel J. Toorop, E. Tournoij, M. Truijers, K. Türkcan, R.P. Tutein Nolthenius, Çağdaş Ünlü, Roel Vaes, A.A. Vafi, A.C. Vahl, Eelco J. Veen, Hugo T.C. Veger, M.G. Veldman, Sebastiaan Velthuis, Hence J.M. Verhagen, B.A. Verhoeven, Christine Vermeulen, E.G. Vermeulen, B.P. Vierhout, R.J. van der Vijver-Coppen, M.J. Visser, J.A. van der Vliet, Christine Keulen, R. Voorhoeve, Joost R. van der Vorst, A. W. Floris Vos, B. de Vos, Cornelis G. Vos, G.A. Vos, Michiel T. Voûte, B.H. Vriens, P.W. Vriens, A.C. de Vries, D.K. de Vries, J.P. de Vries, M. de Vries, C. van der Waal, Evert J. Waasdorp, B.M. Wallis de Vries, L.A. van Walraven, J.L. van Wanroij, Michiel C. Warlé, W. van de Water, Chris van Weel, A.M. van Well, G.M. Welten, R.J. Welten, Jan J. Wever, Arno M. Wiersema, O.R. Wikkeling, W.I. Willaert, J. Wille, M.C. Willems, E.M. Willigendael, E.D. Wilschut, Willem Wisselink, M.E. Witte, C.H.A. Wittens, Ckh Wong, R. Wouda, Ozan Yazar, Kak Khee Yeung, Clark J. Zeebregts, M.L. van Zeeland · 发表于：European Journal of Vascular and Endovascular Surgery · 年份：2021 · DOI：10.1016/j.ejvs.2021.02.047 · 被引用次数：28 · 研究领域：Aortic aneurysm repair treatments、Cardiac, Anesthesia and Surgical Outcomes、Aortic Disease and Treatment Approaches

OBJECTIVE: Age is an independent risk factor for mortality after both elective open surgical repair (OSR) and endovascular aneurysm repair (EVAR). As a result of an ageing population, and the less invasive nature of EVAR, the number of patients over 80 years (octogenarians) being treated is increasing. The mortality and morbidity following aneurysm surgery are increased for octogenarians. However, the mortality for octogenarians who have either low or high peri-operative risks remains unclear. The aim of this study was to provide peri-operative outcomes of octogenarians vs. non-octogenarians after OSR and EVAR for intact aneurysms, including separate subanalyses for elective and urgent intact repair, based on a nationwide cohort. Furthermore, the influence of comorbidities on peri-operative mortality was examined. METHODS: All patients registered in the Dutch Surgical Aneurysm Audit (DSAA) undergoing intact AAA repair between 2013 and 2018, were included. Patient characteristics and peri-operative outcomes (peri-operative mortality, and major complications) of octogenarians vs. non-octogenarians for both OSR and EVAR were compared using descriptive statistics. Multivariable logistic regression analyses were used to examine whether age and the presence of cardiac, pulmonary, or renal comorbidities were associated with mortality. RESULTS: This study included 12 054 EVAR patients (3 015 octogenarians), and 3 815 OSR patients (425 octogenarians). Octogenarians in both the EVAR an...