Zonneveld Bo, Vu Duyen, Kardys Isabella, van Dalen Bas M, Snelder Sanne M
Erasmus University Medical Centre, Rotterdam, the Netherlands.
Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, the Netherlands.
J Obes Metab Syndr. 2021 Dec 30;30(4):377-385. doi: 10.7570/jomes21057.
Obesity is a risk factor not only for abdominal aortic aneurysm (AAA) but also for complications after vascular surgery. This study was to determine the effect of obesity on short-term mortality and post-intervention complications after AAA repair.
A systematic review and meta-analysis were performed. A systematic search was performed in PubMed; the articles describing the differences in post-intervention complications after open or endovascular repair of an AAA between obese and non-obese patients were selected. The primary outcome was short-term mortality defined as in-hospital mortality or mortality within 30 days after AAA repair. The secondary outcomes were cardiac complications, pulmonary failure, renal failure, and wound infections. The meta-analysis was performed using OpenMeta.
Four articles were included in the meta-analysis; these articles included 35,989 patients of which 10,917 (30.3%) were obese. The meta-analysis showed no significant differences for short-term mortality (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.69-1.04). Also, no significant difference was found in pulmonary failure (OR, 1.09; 95% CI, 0.85-1.42). However, obese patients were less likely to suffer from cardiac complications (OR, 0.73; 95% CI, 0.55-0.96). Nevertheless, there was a significantly higher risk of renal failure (OR, 1.16; 95% CI, 1.05-1.30) and wound infections (OR, 1.92; 95% CI, 1.55-2.38) in obese patients.
Obesity is not a risk factor for short-term mortality after AAA repair compared to non-obesity. Moreover, obese patients suffer less from cardiac complications than non-obese patients.
肥胖不仅是腹主动脉瘤(AAA)的危险因素,也是血管手术后并发症的危险因素。本研究旨在确定肥胖对AAA修复术后短期死亡率和干预后并发症的影响。
进行了一项系统评价和荟萃分析。在PubMed中进行了系统检索;选择了描述肥胖和非肥胖患者在AAA开放或血管内修复术后干预后并发症差异的文章。主要结局是短期死亡率,定义为住院死亡率或AAA修复术后30天内的死亡率。次要结局是心脏并发症、肺衰竭、肾衰竭和伤口感染。使用OpenMeta进行荟萃分析。
荟萃分析纳入了4篇文章;这些文章包括35989例患者,其中10917例(30.3%)为肥胖患者。荟萃分析显示短期死亡率无显著差异(优势比[OR],0.85;95%置信区间[CI],0.69-1.04)。此外,肺衰竭也无显著差异(OR,1.09;95%CI,0.85-1.42)。然而,肥胖患者发生心脏并发症的可能性较小(OR,0.73;95%CI,0.55-0.96)。尽管如此,肥胖患者发生肾衰竭(OR,1.16;95%CI,1.05-1.30)和伤口感染(OR,1.92;95%CI,1.55-2.38)的风险显著更高。
与非肥胖相比,肥胖不是AAA修复术后短期死亡的危险因素。此外,肥胖患者心脏并发症的发生率低于非肥胖患者。