title: Early outcomes and perioperative risk assessment in elective open thoracoabdominal aortic aneurysm repair: An analysis of national data over a five-year period.
abstract: Open surgical repair of thoracoabdominal aortic aneurysms remains associated with significant morbidity and mortality. We sought to analyse multicentre national data on early outcomes of open surgical thoracoabdominal aortic aneurysm repair. Patients who underwent open repair of thoracoabdominal aortic aneurysm from 2005 to 2010 were identified from the National Surgical Quality Improvement Program database. The primary endpoint was mortality at 30 days. Patient demographics, clinical variables, and intraoperative parameters were analysed by univariate and multivariate logistic regression methods to identify risk factors for mortality. Of the 682 elective repairs, 30-day outcomes of elective repairs were: 10.0% mortality, 21.6% surgical complications, 42.2% pulmonary complications, 17.2% renal complications, 12.9% cardiovascular complications, 19.2% septic complications, and 6.6% wound complications. Multivariate logistic regression analysis showed that age, ASA-class IV, dependent functional status prior to surgery, and operation time are independent risk factors for mortality. Our study found a higher rate of mortality nationwide, as compared to several previous single center studies.
authors.affiliation: Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA Dayama.md@gmail.com.
authors.forename: Anand
authors.initials: A
authors.lastname: Dayama
authors.affiliation: Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Dordaneh
authors.initials: D
authors.lastname: Sugano
authors.affiliation: Northeast Georgia Physicians Group Surgical Associates Vascular Center, Gainesville, Georgia.
authors.forename: James G
authors.initials: JG
authors.lastname: Reeves
authors.affiliation: Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Aksim
authors.initials: A
authors.lastname: Rivera
authors.affiliation: University Heart and Vascular Center, Hamburg, Germany.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimparis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D016208:Databases, Factual; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: Open thoracoabdominal aortic aneurysm repair; mortality; risk factors