Vogel T R, Symons R G, Flum D R
Robert Wood Johnson Medical School, Division of Vascular Surgery, New Brunswick, New Jersey 08903-0019, USA.
Vasc Endovascular Surg. 2008 Oct-Nov;42(5):412-9. doi: 10.1177/1538574408316143. Epub 2008 Jun 25.
Endovascular abdominal aneurysm repair (EVAR) is increasingly used, but there is insufficient evaluation of long-term outcomes.
Retrospective cohort study using the linked Washington State hospital discharge database.
3,350 patients underwent elective repair of AAA (1181 EVAR) between 2000 and 2005. EVAR patients were older and had higher comorbidity scores. The 30-day readmission rate after EVAR was 11.6%. The 30-day readmissions included cardiac complications (18.5%) and device complications (10.4%). 46% of the 30-day readmissions after EVAR underwent procedures: abdominal/ iliac angiography (7.4%), angioplasty (8.9%), and device revision (8.2%). Mean time to late interventions was 611 days.
Readmission, reintervention, and complication rates after EVAR occur more commonly than previously described. Cardiac complications were the most common readmission. Almost half of the 30-day readmissions required a secondary intervention. Long-term complications after EVAR occurred before two years. Population-based assessment may be more reflective of "real world" complication rates after EVAR.
血管内腹主动脉瘤修复术（EVAR）的应用越来越广泛，但对其长期疗效的评估尚不充分。
利用华盛顿州医院出院数据库进行回顾性队列研究。
2000年至2005年间，3350例患者接受了腹主动脉瘤择期修复术（1181例行EVAR）。接受EVAR的患者年龄更大，合并症评分更高。EVAR术后30天再入院率为11.6%。30天再入院的原因包括心脏并发症（18.5%）和器械并发症（10.4%）。EVAR术后30天再入院患者中有46%接受了手术：腹主动脉/髂动脉血管造影（7.4%）、血管成形术（8.9%）和器械翻修（8.2%）。晚期干预的平均时间为611天。
EVAR术后的再入院、再次干预和并发症发生率比之前报道的更为常见。心脏并发症是最常见的再入院原因。30天再入院患者中近一半需要二次干预。EVAR术后的长期并发症发生在两年之前。基于人群的评估可能更能反映EVAR术后的“真实世界”并发症发生率。
