Mortality following elective abdominal aortic aneurysm repair in women

Dutch Society of Vascular Surgery; V. N. Tedjawirja; A. J. Alberga; M. H.P. Hof; A. C. Vahl; M. J.W. Koelemay; R. Balm

doi:10.1093/bjs/znab465

Mortality following elective abdominal aortic aneurysm repair in women

Dutch Society of Vascular Surgery, V. N. Tedjawirja, A. J. Alberga, M. H.P. Hof, A. C. Vahl, M. J.W. Koelemay, R. Balm^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women.

Methods: Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR).

Results: Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase).

Conclusion: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.

Original language	English
Pages (from-to)	340-345
Number of pages	6
Journal	British Journal of Surgery
Volume	109
Issue number	4
DOIs	https://doi.org/10.1093/bjs/znab465
Publication status	Published - 1-Apr-2022

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@article{ebde332489074f41a60a9260aafd5dce,

title = "Mortality following elective abdominal aortic aneurysm repair in women",

abstract = "Background: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women.Methods: Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR).Results: Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase).Conclusion: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.",

author = "{Dutch Society of Vascular Surgery} and Tedjawirja, {V. N.} and Alberga, {A. J.} and Hof, {M. H.P.} and Vahl, {A. C.} and Koelemay, {M. J.W.} and R. Balm and Ben Saleem",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Oxford University Press on behalf of BJS Society Ltd.",

year = "2022",

month = apr,

day = "1",

doi = "10.1093/bjs/znab465",

language = "English",

volume = "109",

pages = "340--345",

journal = "British Journal of Surgery",

issn = "0007-1323",

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number = "4",

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TY - JOUR

T1 - Mortality following elective abdominal aortic aneurysm repair in women

AU - Dutch Society of Vascular Surgery

AU - Tedjawirja, V. N.

AU - Alberga, A. J.

AU - Hof, M. H.P.

AU - Vahl, A. C.

AU - Koelemay, M. J.W.

AU - Balm, R.

AU - Saleem, Ben

PY - 2022/4/1

Y1 - 2022/4/1

N2 - Background: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women.Methods: Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR).Results: Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase).Conclusion: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.

AB - Background: Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women.Methods: Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR).Results: Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase).Conclusion: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.

U2 - 10.1093/bjs/znab465

DO - 10.1093/bjs/znab465

M3 - Article

C2 - 35237792

AN - SCOPUS:85126830200

SN - 0007-1323

VL - 109

SP - 340

EP - 345

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 4

ER -

Mortality following elective abdominal aortic aneurysm repair in women

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