Frailty in patients with abdominal aortic aneurysm predicts prognosis after elective endovascular aneurysm repair

Autor: Shinichiro Yoshino, Eisuke Kawakubo, Keiji Yoshiya, Tadashi Furuyama, Koichi Morisaki, Ken Nakayama, Takuya Matsumoto, Sho Yamashita, Shun Kurose, Masaki Mori
Rok vydání: 2020
Předmět:
Male
Reoperation
medicine.medical_specialty
Time Factors
Frail Elderly
medicine.medical_treatment
030204 cardiovascular system & hematology
Risk Assessment
Endovascular aneurysm repair
Blood Vessel Prosthesis Implantation
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Aneurysm
Predictive Value of Tests
Risk Factors
medicine.artery
Nutritional risk index
Overall survival
medicine
Humans
In patient
cardiovascular diseases
030212 general & internal medicine
Geriatric Assessment
Aged
Retrospective Studies
Aged
80 and over
Frailty
business.industry
Endovascular Procedures
medicine.disease
Common iliac artery
Abdominal aortic aneurysm
Surgery
Treatment Outcome
Elective Surgical Procedures
Sarcopenia
cardiovascular system
Female
Cardiology and Cardiovascular Medicine
business
Aortic Aneurysm
Abdominal
Zdroj: Journal of Vascular Surgery. 72:138-143
ISSN: 0741-5214
DOI: 10.1016/j.jvs.2019.09.052
Popis: The diagnostic criteria for frailty in patients with abdominal aortic aneurysm (AAA) are undefined. Our purpose was to examine the influence of new diagnostic criteria for frailty on overall survival after endovascular aneurysm repair (EVAR).We retrospectively analyzed data for patients undergoing EVAR between 2007 and 2015. Isolated common iliac artery aneurysm and ruptured AAA were excluded. Patients were defined as having frailty when they had at least two of low Geriatric Nutritional Risk Index, sarcopenia, or nonambulatory status. We examined whether frailty affected overall survival, postoperative complications, and reintervention.Over the study period, 349 patients underwent EVAR. Thirty-three patients were excluded. The 5-year overall survival after EVAR was 76.7% for the frailty-negative group vs 43.1% for the frailty-positive group (P .01). Age, frailty-positive status, and current cancer therapy were risk factors for overall survival. Positive frailty was the only risk factor for postoperative complications. Forty-two patients underwent reintervention. Outside instructions for use was a risk factor for reintervention after EVAR.Assessing frailty in patients with AAA is useful for determining risk factors for 5-year overall survival and postoperative complications.
Databáze: OpenAIRE
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