Nationwide Study to Predict Colonic Ischemia after Abdominal Aortic Aneurysm Repair in The Netherlands

Autor: Saskia Irene Willemsen, Martijn Geert ten Berge, Randolph George Statius van Eps, Hugo Thomas Christian Veger, Hans van Overhagen, Lukas Carolus van Dijk, Hein Putter, Jan Jacob Wever, L.H. Van den Akker, 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, J.G. Baal, O.J. Bakker, R. Balm, W.B. Barendregt, M.H. Bender, B.L. Bendermacher, M. van den Berg, P. Berger, R.J. Beuk, J.D. Blankensteijn, R.J. Bleker, J.H. Bockel, M.E. Bodegom, K.E. Bogt, A.P. Boll, M.H. Booster, B.L. Borger van der Burg, G.J. de Borst, W.T. Bos-van Rossum, J. Bosma, J.M. Botman, L.H. Bouwman, J.C. Breek, V. Brehm, M.J. Brinckman, T.H. van den Broek, H.L. Brom, M.T. de Bruijn, J.L. de Bruin, P. Brummel, J.P. van Brussel, S.E. Buijk, M.G. Buimer, D.H. Burger, H.C. Buscher, G. den Butter, E. Cancrinus, P.H. Castenmiller, G. Cazander, H.M. Coveliers, P.H. Cuypers, J.H. Daemen, I. Dawson, A.F. Derom, A.R. Dijkema, J. Diks, M.K. Dinkelman, M. Dirven, D.E. Dolmans, R.C. van Doorn, L.M. van Dortmont, 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, B. Fioole, W.M. Fritschy, 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, C.E. Hazenberg, P.P. Hedeman Joosten, J.N. Helleman, L.G. van der Hem, J.M. Hendriks, J.A. van Herwaarden, J.M. Heyligers, J.W. Hinnen, R.J. Hissink, G.H. Ho, P.T. den Hoed, M.T. Hoedt, F. van Hoek, R. Hoencamp, W.H. Hoffmann, A.W. Hoksbergen, E.J. Hollander, L.C. Huisman, R.G. Hulsebos, K.M. Huntjens, M.M. Idu, M.J. Jacobs, M.F. van der Jagt, J.R. Jansbeken, R.J. Janssen, H.H. Jiang, S.C. de Jong, V. Jongkind, M.R. Kapma, B.P. Keller, A. Khodadade Jahrome, J.K. Kievit, P.L. Klemm, P. Klinkert, B. Knippenberg, N.A. Koedam, M.J. Koelemaij, J.L. Kolkert, G.G. Koning, O.H. Koning, A.G. Krasznai, R.M. Krol, R.H. Kropman, R.R. Kruse, L. van der Laan, M.J. van der Laan, J.H. van Laanen, J.H. Lardenoye, J.A. Lawson, D.A. Legemate, V.J. Leijdekkers, M.S. Lemson, M.M. Lensvelt, M.A. Lijkwan, R.C. Lind, F.T. van der Linden, P.F. Liqui Lung, M.J. Loos, M.C. Loubert, D.E. Mahmoud, C.G. Manshanden, E.C. Mattens, R. Meerwaldt, B.M. Mees, R. Metz, R.C. Minnee, J.C. de Mol van Otterloo, F.L. Moll, Y.C. Montauban van Swijndregt, M.J. Morak, R.H. van de Mortel, W. Mulder, S.K. Nagesser, C.C. Naves, J.H. Nederhoed, A.M. Nevenzel-Putters, A.J. de Nie, D.H. Nieuwenhuis, J. Nieuwenhuizen, R.C. van Nieuwenhuizen, D. Nio, A.P. Oomen, B.I. Oranen, J. Oskam, H.W. Palamba, A.G. Peppelenbosch, A.S. van Petersen, T.F. Peterson, B.J. Petri, M.E. Pierie, A.J. Ploeg, R.A. Pol, E.D. Ponfoort, P.P. Poyck, A. Prent, S. ten Raa, J.T. Raymakers, M. Reichart, B.L. Reichmann, M.M. Reijnen, A. Rijbroek, M.J. van Rijn, R.A. de Roo, E.V. Rouwet, C.G. Rupert, B.R. Saleem, M.R. van Sambeek, M.G. Samyn, H.P. van’t Sant, J. van Schaik, P.M. van Schaik, D.M. Scharn, M.R. Scheltinga, A. Schepers, P.M. Schlejen, F.J. Schlosser, F.P. Schol, O. Schouten, M.H. Schreinemacher, M.A. Schreve, G.W. Schurink, C.J. Sikkink, M.P. Siroen, A. te Slaa, H.J. Smeets, L. Smeets, A.A. de Smet, P. de Smit, P.C. Smit, T.M. Smits, M.G. Snoeijs, A.O. Sondakh, T.J. van der Steenhoven, S.M. van Sterkenburg, D.A. Stigter, H. Stigter, R.P. Strating, G.N. Stultiëns, J.E. Sybrandy, J.A. Teijink, B.J. Telgenkamp, M.J. Testroote, R.M. The, W.J. Thijsse, I.F. Tielliu, R.B. van Tongeren, R.J. Toorop, J.H. Tordoir, E. Tournoij, M. Truijers, K. Türkcan, R.P. Tutein Nolthenius, Ç. Ünlü, A.A. Vafi, A.C. Vahl, E.J. Veen, H.T. Veger, M.G. Veldman, H.J. Verhagen, B.A. Verhoeven, C.F. Vermeulen, E.G. Vermeulen, B.P. Vierhout, M.J. Visser, J.A. van der Vliet, C.J. Vlijmen-van Keulen, H.G. Voesten, R. Voorhoeve, A.W. Vos, B. de Vos, G.A. Vos, B.H. Vriens, P.W. Vriens, A.C. de Vries, J.P. de Vries, M. de Vries, C. van der Waal, E.J. Waasdorp, B.M. Wallis de Vries, L.A. van Walraven, J.L. van Wanroij, M.C. Warlé, V. van Weel, A.M. van Well, G.M. Welten, R.J. Welten, J.J. Wever, A.M. Wiersema, O.R. Wikkeling, W.I. Willaert, J. Wille, M.C. Willems, E.M. Willigendael, W. Wisselink, M.E. Witte, C.H. Wittens, I.C. Wolf-de Jonge, O. Yazar, C.J. Zeebregts, M.L. van Zeeland
Přispěvatelé: TechMed Centre, Multi-Modality Medical Imaging, Technical Medicine, Surgery, ACS - Atherosclerosis & ischemic syndromes, Medical Biochemistry, ACS - Diabetes & metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, APH - Methodology, APH - Quality of Care
Rok vydání: 2021
Předmět:
Male
Time Factors
medicine.medical_treatment
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
030204 cardiovascular system & hematology
Logistic regression
Endovascular aneurysm repair
030218 nuclear medicine & medical imaging
0302 clinical medicine
Risk Factors
Colon/blood supply
80 and over
Medicine
Aortic Aneurysm
Abdominal/surgery

Netherlands
Aged
80 and over

Univariate analysis
education.field_of_study
Endovascular Procedures
General Medicine
Middle Aged
Abdominal aortic aneurysm
Aortic Aneurysm
Treatment Outcome
Elective Surgical Procedures
Cardiology
Female
Cardiology and Cardiovascular Medicine
Cohort study
medicine.medical_specialty
Colon
Population
Mesenteric Ischemia/diagnosis
Risk Assessment
03 medical and health sciences
Blood Vessel Prosthesis Implantation
Aneurysm
Internal medicine
Humans
Endovascular Procedures/adverse effects
cardiovascular diseases
Blood Vessel Prosthesis Implantation/adverse effects
education
Aged
Retrospective Studies
business.industry
Colonic ischemia
Abdominal/surgery
medicine.disease
Mesenteric Ischemia
Surgery
Emergencies
business
Aortic Aneurysm
Abdominal
Zdroj: Annals of Vascular Surgery, 73, 407-416
Annals of vascular surgery, 73, 407-416. Elsevier
Annals of vascular surgery, 73, 407-416. ELSEVIER SCIENCE INC
Annals of vascular surgery, 73, 407-416. Elsevier Inc.
Annals of Vascular Surgery, 73, 407-416. ELSEVIER SCIENCE INC
Annals of Vascular Surgery, 73, pp. 407-416
ISSN: 0890-5096
Popis: BACKGROUND: Colonic ischemia remains a severe complication after abdominal aortic aneurysm (AAA) repair and is associated with a high mortality. With open repair being one of the main risk factors of colonic ischemia, deciding between endovascular or open aneurysm repair should be based on tailor-made medicine. This study aims to identify high-risk patients of colonic ischemia, a risk that can be taken into account while deciding on AAA treatment strategy.METHODS: A nationwide population-based cohort study of 9,433 patients who underwent an AAA operation between 2014 and 2016 was conducted. Potential risk factors were determined by reviewing prior studies and univariate analysis. With logistic regression analysis, independent predictors of intestinal ischemia were established. These variables were used to form a prediction model.RESULTS: Intestinal ischemia occurred in 267 patients (2.8%). Occurrence of intestinal ischemia was seen significantly more in open repair versus endovascular aneurysm repair (7.6% vs. 0.9%; P < 0.001). This difference remained significant after stratification by urgency of the procedure, in both intact open (4.2% vs. 0.4%; P < 0.001) and ruptured open repair (15.0% vs. 6.2%); P < 0.001). Rupture of the AAA was the most important predictor of developing intestinal ischemia (odds ratio [OR], 5.9, 95% confidence interval [CI] 4.4-8.0), followed by having a suprarenal AAA (OR 3.4; CI 1.1-10.6). Associated procedural factors were open repair (OR 2.8; 95% CI 1.9-4.2), blood loss >1L (OR 3.6; 95% CI 1.7-7.5), and prolonged operating time (OR 2.0; 95% CI 1.4-2.8). Patient characteristics included having peripheral arterial disease (OR 2.4; 95% CI 1.3-4.4), female gender (OR 1.7; 95% CI 1.2-2.4), renal insufficiency (OR 1.7; 1.3-2.2), and pulmonary history (OR 1.6; 95% CI 1.2-2.2). Age CONCLUSIONS: One of the main risk factors is open repair. Several other risk factors can contribute to developing colonic ischemia after AAA repair. The proposed prediction model can be used to identify patients at high risk for developing colonic ischemia. With the current trend in AAA repair leaning toward open repair for better long-term results, our prediction model allows a better informed decision can be made in AAA treatment strategy.
Databáze: OpenAIRE