Literature DB >> 30140519

Complications of Endovascular Aneurysm Repair: Mortality, Myocardial Infarction and Acute Kidney Injury.

Pedro Videira Reis1, Mariana Morgado1, Inês Valdoleiros1, Marina Dias Neto1, Joana Mourão1.   

Abstract

OBJECTIVE: Patients undergoing endovascular aneurysm repair (EVAR) have comorbidities that increase the risk of death, myocardial infarction (MI) and acute kidney injury (AKI). Our aim was to evaluate the incidence and predictors of mortality, MI and AKI after EVAR and to compare AKI incidence with Vascular Surgery Kidney Injury Predictive Score (VSKIPS).
METHODS: We conducted a retrospective study of EVAR procedures performed between March 2006 and November 2013. We defined mortality at 30 days, MI as an increase in troponin level to >0.034 ng mL-1 in the first 72 h and AKI as an increase in creatinine level to >0.3 mg dL-1 in the first 48 h after surgery. Risk factors were analysed using logistic regression calculating Hosmer-Lemeshow test and the area under the receiver operating curve (AUROC).
RESULTS: Ninety-eight patients were included in the study. The incidence of mortality, MI, and AKI was 2%, 5%, and 18%, respectively. AKI increased the risk of MI [odds ratio (OR) 24.4, p=0.006]. Preoperative serum urea level of >50 mg dL-1 (OR 4.97, p=0.038), general anaesthesia (OR 9.64, p=0.002) and surgery duration (OR 1.53, p=0.043) were considered independent predictors of AKI. The AUROC of the AKI model was 0.886 compared with 0.793 of VSKIPS.
CONCLUSION: We found the incidence of mortality, MI and AKI consistent with that of previous studies. However, we may be underestimating the last two because of the short follow-up time. AKI was an independent predictor of MI. Preoperative serum urea level of >50 mg dL-1, general anaesthesia and surgery duration were considered independent predictors of AKI.

Entities:  

Keywords:  Abdominal aortic aneurysm; acute kidney injury; anaesthesia; endovascular procedures; mortality; myocardial infarction

Year:  2017        PMID: 30140519      PMCID: PMC6097855          DOI: 10.5152/TJAR.2018.37929

Source DB:  PubMed          Journal:  Turk J Anaesthesiol Reanim        ISSN: 2149-276X


  19 in total

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4.  Incidence of Acute Kidney Injury (AKI) after Endovascular Abdominal Aortic Aneurysm Repair (EVAR) and Impact on Outcome.

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Review 7.  Systematic review and meta-analysis of the early and late outcomes of open and endovascular repair of abdominal aortic aneurysm.

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9.  Endovascular treatment of complex aortic aneurysms: prevalence of acute kidney injury and effect on long-term renal function.

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Review 10.  Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis.

Authors:  Dustin M Thomas; Edward A Hulten; Shane T Ellis; David M F Anderson; Nathan Anderson; Fiora McRae; Jamil A Malik; Todd C Villines; Ahmad M Slim
Journal:  ISRN Cardiol       Date:  2014-04-02
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