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The UK EndoVascular Aneurysm Repair (EVAR) randomised controlled trials: long-term follow-up and cost-effectiveness analysis.英国血管内动脉瘤修复(EVAR)随机对照试验:长期随访和成本效益分析。
Health Technol Assess. 2018 Jan;22(5):1-132. doi: 10.3310/hta22050.
2
Transverse versus Longitudinal Incisions for Femoral Artery Exposure in Treating Patients with Peripheral Vascular Disease.治疗外周血管疾病患者时,经横向与纵向切口暴露股动脉的比较
Ann Vasc Surg. 2018 Feb;47:143-148. doi: 10.1016/j.avsg.2017.08.019. Epub 2017 Sep 8.
3
Predictors of surgical site infection after open lower extremity revascularization.下肢开放性血管重建术后手术部位感染的预测因素。
J Vasc Surg. 2017 Jun;65(6):1769-1778.e3. doi: 10.1016/j.jvs.2016.11.053.
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Meta-analysis of individual-patient data from EVAR-1, DREAM, OVER and ACE trials comparing outcomes of endovascular or open repair for abdominal aortic aneurysm over 5 years.对来自EVAR-1、DREAM、OVER和ACE试验的个体患者数据进行荟萃分析,比较腹主动脉瘤血管内修复或开放修复5年的结果。
Br J Surg. 2017 Feb;104(3):166-178. doi: 10.1002/bjs.10430.
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Percutaneous access for endovascular aortic aneurysm repair: A systematic review and meta-analysis.经皮血管腔内主动脉瘤修复术的入路:一项系统评价和荟萃分析。
Vascular. 2016 Dec;24(6):638-648. doi: 10.1177/1708538116639201. Epub 2016 Mar 21.
6
Diabetes and Risk of Surgical Site Infection: A Systematic Review and Meta-analysis.糖尿病与手术部位感染风险:一项系统评价与荟萃分析
Infect Control Hosp Epidemiol. 2016 Jan;37(1):88-99. doi: 10.1017/ice.2015.249. Epub 2015 Oct 27.
7
The impact of endovascular repair on specialties performing abdominal aortic aneurysm repair.血管内修复对实施腹主动脉瘤修复的专业领域的影响。
J Vasc Surg. 2015 Sep;62(3):562-568.e3. doi: 10.1016/j.jvs.2015.03.042. Epub 2015 May 5.
8
Percutaneous versus femoral cutdown access for endovascular aneurysm repair.经皮穿刺与股动脉切开入路用于血管内动脉瘤修复术
J Vasc Surg. 2015 Jul;62(1):16-21. doi: 10.1016/j.jvs.2015.01.058. Epub 2015 Mar 28.
9
Incidence and relevance of groin incisional complications after aortobifemoral bypass grafting.
Ann Vasc Surg. 2014 Nov;28(8):1832-9. doi: 10.1016/j.avsg.2014.06.064. Epub 2014 Jul 7.
10
Factors associated with surgical site infection after lower extremity bypass in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI).血管外科学会(SVS)血管质量倡议(VQI)中与下肢搭桥术后手术部位感染相关的因素。
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择期血管腔内腹主动脉瘤修复术中开放暴露股动脉后伤口并发症的相关因素

Factors Associated with Wound Complications after Open Femoral Artery Exposure for Elective Endovascular Abdominal Aortic Aneurysm Repair.

作者信息

Trinidad Bradley, Rybin Denis, Doros Gheorghe, Eslami Mohammad, Tan Tze-Woei

机构信息

Division of Vascular and Endovascular Surgery, University of Arizona Department of Surgery, Banner University Medical Center Tucson, Tucson, Arizona.

Boston University School of Public Health, Boston, Massachusetts.

出版信息

Int J Angiol. 2019 Jun;28(2):124-129. doi: 10.1055/s-0039-1683898. Epub 2019 Mar 28.

DOI:10.1055/s-0039-1683898
PMID:31384110
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6679999/
Abstract

We identified factors that would lead to wound complications after open femoral exposure for endovascular abdominal aortic aneurysm repair (oEVAR). Using the National Surgical Quality Improvement Program dataset (2005-2014), we examined the patients who underwent oEVAR. Patients were stratified on whether they developed postoperative wound complications. Comparisons were made between group with wound complications and those without and adjusted analyses performed to identify variables that independently increased the risk of wound complications. There were 14,868 patients in the study cohort and 2.6% (384 patients) developed wound complications after EVAR. Among those with wound complications, 94% (360 patients) of patients had superficial and deep surgical site infection. Patients who had wound complication were likely to be younger (72.6 vs. 73.7 years old (  = 0.02), functionally dependent (5.4 vs. 2.5%) (  < 0.05), smoker (3 vs. 2.4%, =0.03), female (4 vs. 2.2%), with significantly higher body mass index (31 vs. 28), and more commonly had diabetes (4 vs. 2.4%,  < 0.001) or renal failure (12 vs. 3%,  < 0.001). Although perioperative survival was similar, patients who had wound complications had significantly longer hospital length of stay (LOS) (7.3 ± 12 vs. 3.4 ± 5 days,  < 0.001). Up to 3% patients developed wound complications after open femoral exposure during EVAR with significantly higher LOS and therefore cost utilization.

摘要

我们确定了在开放性股动脉暴露下行血管腔内腹主动脉瘤修复术(oEVAR)后导致伤口并发症的因素。利用国家外科质量改进计划数据集(2005 - 2014年),我们对接受oEVAR的患者进行了研究。根据患者是否发生术后伤口并发症进行分层。对有伤口并发症的组和无伤口并发症的组进行比较,并进行校正分析以确定独立增加伤口并发症风险的变量。研究队列中有14868例患者,2.6%(384例患者)在EVAR后发生伤口并发症。在有伤口并发症的患者中,94%(360例患者)发生了浅表和深部手术部位感染。发生伤口并发症的患者可能更年轻(72.6岁对73.7岁,P = 0.02),功能依赖(5.4%对2.5%)(P < 0.05),吸烟(3%对2.4%,P = 0.03),女性(4%对2.2%),体重指数显著更高(31对28),更常见的是患有糖尿病(4%对2.4%,P < 0.001)或肾衰竭(12%对3%,P < 0.001)。尽管围手术期生存率相似,但有伤口并发症的患者住院时间显著更长(7.3±12天对3.4±5天,P < 0.001)。高达3%的患者在EVAR期间开放性股动脉暴露后发生伤口并发症,住院时间显著更长,因此成本更高。