Ntalouka Maria P, Nana Petroula, Brotis Alexandros, Chatzis Athanasios, Mermiri Maria, Stamoulis Konstantinos, Bareka Metaxia, Giannoukas Athanasios, Matsagkas Miltiadis, Arnaoutoglou Eleni
Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110 Larissa, Greece.
Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110 Larissa, Greece.
J Clin Med. 2023 Sep 16;12(18):6004. doi: 10.3390/jcm12186004.
We evaluated the 30-day postoperative outcome after elective endovascular aneurysm repair (EVAR) and the possible predictors for the 30-day postoperative outcome.
Demographics, medical history, laboratory values, intensive care unit (ICU) admission and 30-day complications classified as major (major adverse cardiovascular events (MACEs), acute kidney injury (AKI) and death of any cause) and minor (postimplantation syndrome (PIS), postoperative delirium (POD), urinary tract infection (UTI) and technical graft failure) were documented (March 2016 to February 2019).
We included 322 patients. The majority were managed under general anesthesia (83%) with femoral cutdown (98.1%). Overall, 121 (37.5%) complications, mostly minor ( = 103, 31.9%), were recorded. In total, 11 patients (3.4%) developed MACEs, 5 (1.6%) experienced AKI and 2 (0.6%) died in the ICU. Moreover, 77 patients (23.9%) suffered from PIS, 11 from POD, 11 from UTI and 4 from technical graft failure. The multivariate logistic regression analysis revealed that aneurysm diameter ( = 0.01) and past smoking ( = 0.003) were predictors for complications. PAD was an independent predictor of MACEs ( = 0.003), preoperative neutrophil to lymphocyte ratio (NLR) of AKI ( = 0.003) and past smoking of PIS ( = 0.008), respectively.
Our study showed that the 30-day morbidity after EVAR exceeded 35%. However, the majority of complications were minor, and the associated mortality was low. Aneurysm diameter and past smoking were independent predictors for postoperative outcome.
我们评估了择期血管内动脉瘤修复术（EVAR）术后30天的结局以及术后30天结局的可能预测因素。
记录了2016年3月至2019年2月期间患者的人口统计学资料、病史、实验室检查值、重症监护病房（ICU）收治情况以及30天并发症，并发症分为严重并发症（主要不良心血管事件（MACE）、急性肾损伤（AKI）和任何原因导致的死亡）和轻微并发症（植入后综合征（PIS）、术后谵妄（POD）、尿路感染（UTI）和技术性移植物失败）。
我们纳入了322例患者。大多数患者在全身麻醉（83%）下采用股动脉切开术（98.1%）进行治疗。总体而言，共记录到121例（37.5%）并发症，其中大多数为轻微并发症（n = 103，31.9%）。共有11例患者（3.4%）发生MACE，5例（1.6%）发生AKI，2例（0.6%）在ICU死亡。此外，77例患者（23.9%）患有PIS，11例患有POD，11例患有UTI，4例发生技术性移植物失败。多因素逻辑回归分析显示，动脉瘤直径（P = （此处原文有误，推测为P = 0.01））和既往吸烟史（P = 0.003）是并发症的预测因素。外周动脉疾病（PAD）分别是MACE的独立预测因素（P = 0 .003）、AKI的术前中性粒细胞与淋巴细胞比值（NLR）的独立预测因素（P = 0.003）以及PIS的既往吸烟史的独立预测因素（P = 0.008）。
我们的研究表明，EVAR术后30天的发病率超过35%。然而，大多数并发症为轻微并发症，相关死亡率较低。动脉瘤直径和既往吸烟史是术后结局的独立预测因素。
