FIGURE 1.
FIGURE 2.
FIGURE 3.
FIGURE 4.
Correlational analysis of potential predictors of in-hospital and 1-year mortality following AAA treatment
| Proposed predictors | Deceased in hospital (n = 30) | Discharged alive (n =87) | p value | Deceased at 1 year (n = 34) | Alive at 1 year (n = 63) | p value |
|---|---|---|---|---|---|---|
| Included from Târgu Mureș (n, %) | 21 (70.0) | 52 (59.8) | 0.38 | 26 (76.5) | 38 (60.3) | 0.12 |
| Age (years)* | 73.5 (54–84) | 68 (51–87) | <0.01 | 74 (54–87) | 68 (51–82) | <0.001 |
| Male sex (n, %) | 25 (83.3) | 80 (92.0) | 0.18 | 29 (85.3) | 58 (92.1) | 0.31 |
| Maximum aortic diameter (mm)* | 89.5 (40–160) | 64 (30–150) | <0.001 | 88 (40–160) | 64 (30–120) | 0.001 |
| Presence of aortic rupture (n, %) | 29 (96.7) | 17 (19.5) | <0.001 | 31 (91.2) | 12 (19.0) | <0.001 |
| Hemoglobin concentration (g/dl)* | 9.85 (5.2–14.6) | 13.2 (6.5–17.9) | <0.001 | 9.85 (5.2–15.3) | 13.3 (6.8–17.9) | <0.001 |
| Serum creatinine (mg/dl)* | 1.45 (0.72–6.69) | 1.01 (0.61–5.8) | <0.001 | 1.42 (0.81–6.69) | 0.96 (0.61–2.91) | <0.001 |
| Arterial hypertension (n, %) | 18 (60.0) | 74 (85.1) | <0.01 | 20 (58.8) | 55 (87.3) | <0.01 |
| Diabetes mellitus (n, %) | 5 (16.7) | 21 (24.1) | 0.45 | 7 (20.6) | 13 (20.6) | 1.00 |
| Cardiovascular disease history (n, %) | 15 (50.0) | 30 (34.5) | 0.19 | 15 (44.1) | 22 (34.9) | 0.38 |
| Pulmonary disease history (n, %) | 4 (13.3) | 12 (13.8) | 1.00 | 4 (11.8) | 9 (14.3) | 1.00 |
| Cerebrovascular disease history (n, %) | 5 (16.7) | 1 (1.1) | <0.001 | 5 (14.7) | 1 (1.6) | 0.01 |
| EVAR as treatment (n, %) | 2 (6.7) | 55 (63.2) | <0.001 | 4 (11.8) | 37 (58.7) | <0.001 |
| Any postoperative complication (n, %) | 28 (93.3) | 16 (18.4) | <0.001 | 30 (88.2) | 10 (15.9) | <0.001 |
Postoperative complications in the analyzed patient population
| Parameter | EVAR (n = 57) | OSR (n = 60) | p value | Ruptured AAA (n = 46) | Non-ruptured AAA (n = 71) | p value |
|---|---|---|---|---|---|---|
| Hemorrhage (n, %) | 1 (1.8) | 17 (28.3) | <0.001 | 18 (39.1) | 0 (0.0) | <0.001 |
| Infection (n, %) | 4 (7.0) | 7 (11.7) | 0.52 | 7 (15.2) | 4 (5.6) | 0.10 |
| Stroke (n, %) | 1 (1.8) | 1 (1.7) | 1.00 | 2 (4.3) | 0 (0.0) | 0.15 |
| Acute coronary syndrome (n, %) | 0 (0.0) | 10 (16.7) | 0.001 | 10 (21.7) | 0 (0.0) | <0.001 |
| Mesenteric ischemia (n, %) | 0 (0.0) | 6 (10.0) | 0.02 | 6 (13.0) | 0 (0.0) | <0.01 |
| Dialysis (n, %) | 1 (1.8) | 14 (23.3) | <0.001 | 15 (32.6) | 0 (0.0) | <0.001 |
| Respiratory failure (n, %) | 2 (3.5) | 4 (6.7) | 0.67 | 5 (10.9) | 1 (1.4) | 0.03 |
| Endoleak (n, %) | 1 (1.8) | 0.0 | 0.48 | 0 (0.0) | 1 (1.4) | 1.00 |
| Other significant complications (n, %) | 0 (0.0) | 28 (46.7) | <0.001 | 27 (58.7) | 1 (1.4) | <0.001 |
Multivariate stepwise regression models predicting mortality
| Model | Deceased in hospital | Deceased at 1 year | Cox regression |
|---|---|---|---|
| Included from Cluj-Napoca (Târgu Mureș as reference) | – | – | 0.454 (p = 0.046) |
| Age (years) | – | 0.205 (p = 0.002) | 1.002 (p = 0.934) |
| Male sex | – | – | 1.516 (p = 0.402) |
| Maximum aortic diameter (mm) | 0.029 (p = 0.044) | 0.049 (p = 0.020) | – |
| Hemoglobin concentration (g/dl) | – | – | – |
| Serum creatinine (mg/dl) | – | 1.504 (p = 0.025) | – |
| Arterial hypertension | –1.413 (p = 0.090) | –1.877 (p = 0.083) | – |
| Cardiovascular and cerebrovascular disease history | 2.727 (p = 0.003) | – | 2.101 (p = 0.035) |
| Pulmonary disease history | – | – | – |
| OSR (EVAR as reference) | 2.192 (p = 0.034) | – | 2.778 (p = 0.044) |
| Any postoperative complications | 3.799 (p < 0.001) | 2.618 (p = 0.001) | 8.457 (p < 0.001) |
Demographic and clinical variables of the analyzed patient population, considering the applied aortic reconstruction strategy and aneurysm rupture
| Parameter | EVAR (n = 57) | OSR (n = 60) | p value | Ruptured AAA (n = 46) | Non-ruptured AAA (n = 71) | p value |
|---|---|---|---|---|---|---|
| Included from Târgu Mureș (n, %) | 37 (64.9) | 36 (60.0) | 0.70 | 29 (63.0) | 44 (62.0) | 1.00 |
| Age (years)* | 67 (51–82) | 72 (52–87) | 0.07 | 73.0 (52–87) | 68 (51–82) | 0.01 |
| Male sex (n, %) | 53 (93.0) | 52 (86.7) | 0.36 | 41 (89.1) | 64 (90.1) | 1.00 |
| Emergent presentation (n, %) | 13 (22.8) | 48 (80.0) | <0.001 | 46 (100) | 15 (21.1) | <0.001 |
| Maximum aortic diameter (mm)* | 63 (37–120) | 80 (30–160) | <0.01 | 88 (33–160) | 63 (30–120) | <0.001 |
| Hemoglobin concentration (g/dl)* | 13.3 (7.4–17.9) | 10.42 (5.2–16.0) | <0.001 | 9.65 (5.2–14.6) | 13.6 (7.4–17.9) | <0.001 |
| Serum creatinine (mg/dl)* | 0.95 (0.73–2.40) | 1.28 (0.61–6.69) | <0.001 | 1.42 (0.72–6.69) | 0.98 (0.61–2.40) | <0.001 |
| Arterial hypertension (n, %) | 47 (82.5) | 45 (75.0) | 0.37 | 31 (67.4) | 61 (85.9) | 0.02 |
| Diabetes mellitus (n, %) | 11 (19.3) | 15 (25.0) | 0.50 | 9 (19.6) | 17 (23.9) | 0.65 |
| Cardiovascular disease history (n, %) | 19 (33.3) | 26 (43.3) | 0.32 | 17 (37.0) | 28 (39.4) | 0.84 |
| Pulmonary disease history (n, %) | 8 (14.0) | 8 (13.3) | 1.00 | 6 (13.0) | 10 (14.1) | 1.00 |
| Cerebrovascular disease history (n, %) | 0 (0.0) | 6 (10.0) | 0.02 | 5 (10.9) | 1 (1.4) | 0.03 |
| In-hospital mortality (n, %) | 2 (3.5) | 28 (46.7) | <0.001 | 29 (63.0) | 1 (1.4) | <0.001 |
| 1-year mortality (n, %) | 4 (9.8) | 30 (53.6) | <0.001 | 31 (72.6) | 3 (5.6) | <0.001 |
Association between clinical parameters and postoperative complications
| Proposed predictors | With complications (n = 44) | Without complications (n = 73) | p value |
|---|---|---|---|
| Included from Târgu Mureș (n, %) | 29 (65.9) | 44 (60.3) | 0.56 |
| Age (years)* | 73.5 (54–87) | 68 (51–84) | <0.01 |
| Male sex (n, %) | 39 (88.6) | 66 (90.4) | 0.76 |
| Maximum aortic diameter (mm)* | 82 (30–160) | 63 (37–120) | <0.001 |
| Presence of aortic rupture (n, %) | 38 (86.4) | 8 (11.0) | <0.001 |
| Hemoglobin concentration (g/dl)* | 9.55 (5.2–14.8) | 13.4 (8.3–17.9) | <0.001 |
| Serum creatinine (mg/dl)* | 1.38 (0.72–6.69) | 1.01 (0.61–2.40) | <0.001 |
| Arterial hypertension (n, %) | 29 (65.9) | 63 (86.3) | 0.01 |
| Diabetes mellitus (n, %) | 10 (22.7) | 16 (21.9) | 1.00 |
| Cardiovascular disease history (n, %) | 17 (38.6) | 28 (38.4) | 1.00 |
| Pulmonary disease history (n, %) | 4 (9.1) | 12 (16.4) | 0.40 |
| Cerebrovascular disease history (n, %) | 5 (11.4) | 1 (1.4) | 0.02 |
| EVAR as treatment (n, %) | 5 (11.4) | 52 (71.2) | <0.001 |
Length of hospitalization and total costs per patient
| Parameter | EVAR (n = 57) | OSR (n = 60) | p value | Ruptured AAA (n = 46) | Non-ruptured AAA (n = 71) | p value |
|---|---|---|---|---|---|---|
| Length of hospital stay (days) | 8.0 (3–83) | 8.5 (0–50) | 0.44 | 6.0 (0.0–50.0) | 9.0 (3.0–83.0) | <0.01 |
| Length of ICU stay (days) | 1.0 (0.2–10.3) | 2.45 (0.0–42.7) | <0.01 | 2.7 (0.0–42.7) | 1.0 (0.2–8.0) | <0.01 |
| Preoperative period (days) | 3.0 (0.0–70.0) | 0.0 (0.0–9.0) | <0.001 | 0.0 (0.0–8.0) | 2.0 (0.0–70.0) | <0.001 |
| Total costs without specific medical devices (Euro) | 4,097 (1,195–22,606) | 5,430 (131–67,646) | 0.84 | 5,619 (131–67,646) | 4,306 (1,195–22,606) | 0.84 |
| Total costs including specific medical devices (Euro) | 13,734 (10,016–40,363) | 5,989 (690–68,205) | <0.001 | 6,178 (690–68,205) | 13,131 (3,107–40,363) | <0.001 |