title: The impact of diabetes mellitus and renal insufficiency on the outcome of endovascular abdominal aortic aneurysm repair.
abstract: The purpose of this study was to determine the effects of diabetes mellitus (DM) and renal insufficiency (RI) on outcomes following endovascular abdominal aneurysms repair (EVAR). The surgical outcomes associated with endovascular repair in 12 451 patients are reported. After adjusting for confounders, DM and RI were analyzed against the primary outcome variables of mortality, major complications, length of stay, treatment cost, and routine discharge rates. This study shows that RI has a greater negative influence on the outcome of EVAR than previously suspected and that a conservative approach to the use of EVAR in patients with RI is warranted. While DM has negative impact on outcomes following open repair of abdominal aortic aneurysms, this study shows that it may confer less of a risk than previously thought, when confounders are controlled for, and that EVAR might be a favorable treatment modality for patients with abdominal aortic aneurysm and coexisting DM.
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Jovan N
authors.initials: JN
authors.lastname: Markovic
authors.forename: Dimple D
authors.initials: DD
authors.lastname: Rajgor
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Shortell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D016009:Chi-Square Distribution; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010351:Patient Discharge; D018579:Patient Selection; D051437:Renal Insufficiency / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology