title: Preoperative spirometry results as a determinant for long-term mortality after EVAR for AAA.
abstract: OBJECTIVE
  The aim of this study was to analyse lung function test determinants for long-term mortality after standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Three-hundred and four consecutive patients treated electively with EVAR (Zenith(®) stent grafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerised database.
  
  
  METHODS
  The Global Initiative for Chronic Obstructive Lung Diseases (GOLD) guideline was used to grade the severity of obstructive lung disease. Mortality was checked until 1 December 2010. Median follow-up time was 68 (interquartile range (IQR) 40-94) months.
  
  
  RESULTS
  The percentage of patients with mild, moderate or severe (grade 3) chronic obstructive pulmonary disease (COPD) was 9.9%, 23.2% and 7.7%, respectively. In a combined medical severity assessment, arterial partial pressure of oxygen (PaO(2)) < 8.0 kPa or COPD, grade ≥3 (hazard ratio (HR) 2.06; 95% confidence interval (CI) (1.24-3.42)), anaemia (HR 1.72; 95% CI (1.21-2.44)), chronic kidney disease, stage ≥3 (HR 1.55; 95% CI (1.08-2.24)) and age ≥80 years (HR 1.55; 95% CI (1.04-2.31)) were independently associated with long-term mortality. Lower forced expiratory volume in 1 s (FEV(1)) (p = 0.002) and lower forced vital capacity (FVC) (p = 0.003) were independently associated with long-term mortality.
  
  
  CONCLUSIONS
  Our findings strengthen the need for formal evaluation of lung function with spirometry prior to proceeding to AAA repair.
authors: Eksjö County Hospital, Eksjö, Sweden.
authors: T
authors: T
authors: Ohrlander
authors: M
authors: M
authors: Dencker
authors: S
authors: S
authors: Acosta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001784:Blood Gas Analysis; D019917:Blood Vessel Prosthesis Implantation / Q000401:mortality*; D016009:Chi-Square Distribution; D019992:Databases as Topic; D057510:Endovascular Procedures / Q000401:mortality*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013147:Spirometry; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity