Predicting reinterventions after open and endovascular aneurysm repair using the St George's Vascular Institute score
| Autor: | Jorg Lucas de Bruin, Alan Karthikesalingam, Peter J. Holt, Monique Prinssen, Matt M. Thompson, Jan D. Blankensteijn, D.E. Grobbee, J.D. Blankensteijn, A.A.A. Bak, J. Buth, P.M. Pattynama, E.L.G. Verhoeven, A.E. van Voorthuisen, R. Balm, P.W.M. Cuypers, M. Prinssen, M.R.H.M. van Sambeek, A.F. Baas, M.G. Hunink, J.M. van Engelshoven, M.J.H.M. Jacobs, B.A.J.M. de Mol, J.H. van Bockel, J. Reekers, X. Tielbeek, W. Wisselink, N. Boekema, L.M. Heuveling, I. Sikking, J.L. de Bruin, A.V. Tielbeek, J.A. Reekers, P. Pattynama, T. Prins, A.C. van der Ham, J.J.I.M. van der Velden, S.M.M. van Sterkenburg, G.B. ten Haken, C.M.A. Bruijninckx, H. van Overhagen, R.P. Tutein Nolthenius, T.R. Hendriksz, J.A.W. Teijink, H.F. Odink, A.A.E.A. de Smet, D. Vroegindeweij, R.M.M. van Loenhout, M.J. Rutten, J.F. Hamming, L.E.H. Lampmann, M.H.M. Bender, H. Pasmans, A.C. Vahl, C. de Vries, A.J.C. Mackaay, L.M.C. van Dortmont, A.J. van der Vliet, L.J. Schultze Kool, J.H.B. Boomsma, H.R. van, J.C.A. de Mol van Otterloo, T.P.W. de Rooij, T.M. Smits, E.N. Yilmaz, F.G. van den Berg, M.J.T. Visser, E. van der Linden, G.W.H. Schurink, M. de Haan, H.J. Smeets, P. Stabel, F. van Elst, J. Poniewierski, F.E.G. Vermassen |
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| Přispěvatelé: | Epidemiologie, RS: FHML non-thematic output, RS: CAPHRI - R5 - Optimising Patient Care, RS: CARIM - R3.08 - Regenerative and reconstructive medicine for vascular disease, Surgery, ICaR - Ischemia and repair, Cardiothoracic Surgery, Radiology and Nuclear Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Time Factors medicine.medical_treatment Kaplan-Meier Estimate 030204 cardiovascular system & hematology 030230 surgery Risk Assessment Endovascular aneurysm repair Disease-Free Survival Decision Support Techniques law.invention Blood Vessel Prosthesis Implantation 03 medical and health sciences Aortic aneurysm Postoperative Complications 0302 clinical medicine Aneurysm Belgium Randomized controlled trial Predictive Value of Tests Risk Factors law Multicenter trial medicine Journal Article Humans Comparative Study Aged Netherlands business.industry Endovascular Procedures Hazard ratio Middle Aged medicine.disease Abdominal aortic aneurysm Surgery Multicenter Study Treatment Outcome Randomized Controlled Trial Female business Cardiology and Cardiovascular Medicine Aortic Aneurysm Abdominal Abdominal surgery |
| Zdroj: | Journal of Vascular Surgery, 63(6), 1428. Mosby Inc. Journal of Vascular Surgery, 63(6), 1428-1433. MOSBY-ELSEVIER Journal of Vascular Surgery, 63(6), 1428-1433.e1. Mosby Inc. Journal of vascular surgery, 63(6), 1428-1433.e1. Mosby Inc. de Bruin, J L, Karthikesalingam, A, Holt, P J, Prinssen, M, Thompson, M M & Blankensteijn, J D 2016, ' Predicting reinterventions after open and endovascular aneurysm repair using the St George's Vascular Institute score ', Journal of Vascular Surgery, vol. 63, no. 6, pp. 1428-1433.e1 . https://doi.org/10.1016/j.jvs.2015.12.028 |
| ISSN: | 0741-5214 |
| Popis: | Background: Identifying patients at risk for aneurysm rupture and sac expansion after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) may help to attenuate this risk by intensifying follow-up and early detection of problems. The goal of this study was to validate the St George’s Vascular Institute (SGVI) score to identify patients at risk for a secondary intervention after elective aneurysm repair. Methods: A post hoc on-treatment analysis of a randomized trial comparing open AAA repair and EVAR was performed. In this multicenter trial, 351 patients were randomly assigned to undergo open AAA repair or EVAR. Information on survival and reinterventions was available for all patients at 5 years postoperatively, for 79% at 6 years, and for 53% at 7 years. Open repair was completed in 173 patients and EVAR in 171, based on an on-treatment analysis. Because 17 patients had incomplete anatomic data, 327 patients (157 open repair and 170 EVAR) were available for analysis. During 6 years of follow-up, 78 patients underwent at least one reintervention. The SGVI score, which is calculated from preoperative AAA morphology using aneurysm and iliac diameter, predictively dichotomized patients into groups at highrisk or low-risk for a secondary intervention. The observed freedom from reintervention was compared between groups at predicted high-risk and predicted low-risk. Results: The 20 patients in the high-risk group were indeed at higher risk for a secondary intervention compared with the 307 patients predicted to be at low risk (hazard ratio [HR], 3.82; 95% confidence interval [CI], 2.05-7.11; P < .001). Discrimination between high-risk and low-risk groups was valid for EVAR (HR, 4.06; 95% CI, 1.93-8.51; P < .001) and for open repair (HR, 3.41; 95% CI, 1.02-11.4; P [ .033). Conclusions: The SGVI score appears to be a useful tool to predict reintervention risk in patients after open repair and EVAR. |
| Databáze: | OpenAIRE |
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