Scoring system to predict mid-term adverse events after elective thoracic endovascular aortic repair.

Autor:	Ouchi T; Department of Radiology, Mie University Hospital, Mie, Japan., Kato N; Department of Radiology, Mie University Hospital, Mie, Japan. Electronic address: nkato@med.mie-u.ac.jp., Kato H; Department of Radiology, Mie University Hospital, Mie, Japan., Higashigawa T; Department of Radiology, Mie University Hospital, Mie, Japan., Ito H; Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, Mie, Japan., Nakajima K; Department of Radiology, Ise Red Cross Hospital, Mie, Japan., Tokui T; Department of Thoracic Surgery, Ise Red Cross Hospital, Mie, Japan., Oue K; Department of Cardiovascular Surgery, Kochi Health Sciences Center, Kochi, Japan., Mizumoto T; Department of Cardiovascular Surgery, Anjo Kosei Hospital, Aichi, Japan., Sakuma H; Department of Radiology, Mie University Hospital, Mie, Japan.
Jazyk:	angličtina
Zdroj:	The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2024 Aug 26. Date of Electronic Publication: 2024 Aug 26.
DOI:	10.1016/j.jtcvs.2024.08.034
Abstrakt:	Objective: To develop and validate a scoring system to predict mid-term adverse events after elective thoracic endovascular aortic repair (TEVAR). Methods: In this multicenter retrospective observational cohort study, 350 patients who underwent elective TEVAR for thoracic aortic disease between January 2008 and December 2021 were analyzed. The primary outcome was the first adverse event occurring within 5 years of the initial TEVAR, which included death during the initial hospitalization, perioperative neurologic complication, stent graft-induced new entry, dissection, rupture, graft infection, and reintervention related to the initial TEVAR. The scoring system was developed using the regression coefficients of the Fine-Gray subdistribution hazard model. Its performance was evaluated using the area under the receiver operating characteristic curve (AUC) for competing risk analysis and internally validated by cross-validation. Results: Eighty-two patients experienced at least 1 adverse event within 5 years of the initial TEVAR. The 5-year cumulative incidence of adverse events was 26% (95% confidence interval, 21%-31%). Female sex, comorbidity score, use of anticoagulants, preoperative aortic diameter at the diaphragm level, proximal oversizing ratio, aortic coverage length, and hybrid procedure were included in the scoring system. The AUC of the scoring system in the internal validation was 0.748 (standard error, 0.009). When the scoring system was validated in patients with intact thoracic aortic aneurysm only, the AUC was 0.780 (standard error, 0.012). Conclusions: Although external validation is needed, our scoring system may be useful for decision making, especially in patients with an intact thoracic aortic aneurysm. Competing Interests: Conflict of Interest Statement The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. (Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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