M Boult1, G Maddern, M Barnes, R Fitridge. 1. Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Stepney, SA.
Abstract
OBJECTIVES: To determine the effect of pre-operative factors on mid-term survival of patients enrolled in an Australian audit of endovascular aneurysm repair (EVAR). DESIGN: Prospective longitudinal national register (audit) of patients undergoing EVAR. METHODS: 961 individuals who had elective or semi-urgent EVAR of abdominal aortic aneurysms were enrolled in the audit between November 1999 and May 2001. Data was contributed by 81 surgeons from 64 hospitals. Kaplan-Meier survival analysis was used to determine survival rates and factors significantly influencing survival. Parametric survival analysis with log-exponential distribution was used to estimate expected 3 and 5 year survival for different ages, ASA, creatinine and aneurysm sizes. RESULTS: Overall survival was 93% at 1 year, 80% at 3 years and 67% at five years. Survival rates were found to be statistically associated with ASA, age, aneurysm size and creatinine levels. ASA has the largest effect. Five year survival rates for aneurysms >or=65 mm and <55 mm were 54% and 76% respectively. Pre-operative creatinine levels >or=160 micromol/L lowered the survival rate from 71% to 40%. CONCLUSIONS: Survival for EVAR patients is strongly correlated with a number of pre-operative factors. This survival analysis provides a useful decision-making tool for surgeons particularly for individuals with smaller aneurysms.
OBJECTIVES: To determine the effect of pre-operative factors on mid-term survival of patients enrolled in an Australian audit of endovascular aneurysm repair (EVAR). DESIGN: Prospective longitudinal national register (audit) of patients undergoing EVAR. METHODS: 961 individuals who had elective or semi-urgent EVAR of abdominal aortic aneurysms were enrolled in the audit between November 1999 and May 2001. Data was contributed by 81 surgeons from 64 hospitals. Kaplan-Meier survival analysis was used to determine survival rates and factors significantly influencing survival. Parametric survival analysis with log-exponential distribution was used to estimate expected 3 and 5 year survival for different ages, ASA, creatinine and aneurysm sizes. RESULTS: Overall survival was 93% at 1 year, 80% at 3 years and 67% at five years. Survival rates were found to be statistically associated with ASA, age, aneurysm size and creatinine levels. ASA has the largest effect. Five year survival rates for aneurysms >or=65 mm and <55 mm were 54% and 76% respectively. Pre-operative creatinine levels >or=160 micromol/L lowered the survival rate from 71% to 40%. CONCLUSIONS: Survival for EVAR patients is strongly correlated with a number of pre-operative factors. This survival analysis provides a useful decision-making tool for surgeons particularly for individuals with smaller aneurysms.
Authors: S S Bahia; P J E Holt; D Jackson; B O Patterson; R J Hinchliffe; M M Thompson; A Karthikesalingam Journal: Eur J Vasc Endovasc Surg Date: 2015-06-23 Impact factor: 7.069