Linked Life Data

9302059

Source:http://linkedlifedata.com/resource/pubmed/id/9302059

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1997-10-23
pubmed:abstractText
During 1989, 28 centers of the Association for Academic Research in Vascular Surgery (AURC) reported all cases involving patients with infrarenal abdominal aortic aneurysm (AAA) who reached the operating room alive. In a total series of 1107 procedures, 834 were performed electively. During 1993 and 1994, an effort was made to contact and, if possible re-examine the 794 (95.2%) patients who survived these elective procedures in order to establish survival curves, determine the causes of late death, and ascertain the predictive value for long-term survival of 628 perioperative variables recorded in 1989. Survival curves were calculated using the actuarial and Kaplan-Meier methods and compared with those obtained from national statistical records in a control population matched for age and sex. Variables with potential predictive value for late death were selected by univariate statistical analysis using either the chi2 or student t-test. In the group of 794 (92.5%) patients who survived elective AAA repair in 1989, survival rates were 93.9 +/- 1.8% at 1 year, 89.5 +/- 3.2% at 2 years, 83.5 +/- 3.2% at 3 years, 77.6 +/- 3.9% at 4 years, and 66.9 +/- 10.6% at 5 years. These rates were significantly lower than those observed in the control population. The mean annual death rate from cardiovascular disease was 1.8%, which was higher than in the control population matched for age and sex. Analysis using the Cox proportional risk model showed that the following variables were significant, independent predictors of late death: diameter of aneurysm (p < 0.02), choice of surgical approach in function of general status (p < 0.02), left ventricular insufficiency (p < 0.02), age (p < 0.02), carotid artery occlusion (p < 0.03), use of a surgical approach other than lobotomy (p < 0.04), cardiac arrhythmia (p < 0.04), duration of aortic clamping (p < 0.05), ECG evidence of myocardial ischemia (p < 0.05), abnormality at the upper limit of the aneurysm (p < 0.05), and advanced renal insufficiency (p < 0.05). Life expectancy in patients that undergo successful AAA repair is lower than in the general population. Although death is often unrelated to AAA or the repair procedure, the incidence of morbidity due to cardiovascular disease is higher than in a control population matched for age and sex. These findings suggest that better management of concurrent cardiovascular disease during the perioperative period and long-term follow-up holds the key to improving life expectancy in patients undergoing AAA repair.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0890-5096
pubmed:author
pubmed:issnType
Print
pubmed:volume
11
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
473-81
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1997
pubmed:articleTitle
Long-term survival after elective repair of infrarenal abdominal aortic aneurysm: results of a prospective multicentric study. Association for Academic Research in Vascular Surgery (AURC).
pubmed:affiliation
Service de Chirurgie Vasculaire, CHU Pitié-Salpêtrière, Paris, France.
pubmed:publicationType
Journal Article, Multicenter Study