Influence of obesity on in-hospital and midterm outcomes after endovascular repair of abdominal aortic aneurysm.
OBJECTIVE
To evaluate the influence of obesity on outcomes after endovascular aneurysm repair (EVAR).


METHODS
A retrospective analysis was conducted of 80 patients (77 men; mean age 75.0+/-7.6 years) undergoing elective EVAR for abdominal aortic aneurysm (AAA) between 2001 and 2008. Patients were stratified on presence of obesity [body mass index (BMI) >or=30 kg/m(2)). Outcomes in-hospital and during follow-up were compared between obese and non-obese patients.


RESULTS
In this cohort, 26 (33%) patients had a BMI >or=30 kg/m(2). Mean BMI in the non-obese group was 25.6 kg/m(2) versus 34.1 kg/m(2) in the obese group (p<0.001). In obese patients, EVAR operating time was longer compared to non-obese patients: 217 versus 177 minutes (p = 0.006). One obese patient died after EVAR (p = 0.325); the combined operative mortality and major complication rate was 8% (n = 2) in the obese group versus 7% (n = 4) in the non-obese group (p = NS). Endoleak occurred in 25% (n = 6) of the obese group versus 14% (n = 7) of the non-obese group (p = 0.261). Postoperative intensive care for >24 hours (65% versus 70%, p = 0.796) and overall length of stay (3.9 versus 3.8 days, p = 0.845) did not differ significantly; neither did all-cause mortality during 2 years of follow-up (p = 0.688).


CONCLUSIONS
Obesity is associated with extended operation times during EVAR, but increasing BMI appears to have little influence on outcomes after EVAR. A preferential approach to offering EVAR for obese patients may be reasonable.
Jonker
Frederik H W
FH
Section of Vascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA. frederik.jonker@yale.edu
Schlösser
Felix J V
FJ
Dewan
Michael
M
Huddle
Matthew
M
Sergi
Michael
M
Dardik
Alan
A
Muhs
Bart E
BE
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D009765:Obesity / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome