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Elective Open Suprarenal Aneurysm Repair in England from 2000 to 2010 an Observational Study of Hospital Episode Statistics

Karthikesalingam, A; Holt, PJ; Patterson, BO; Vidal-Diez, A; Sollazzo, G; Poloniecki, JD; Hinchliffe, RJ; Thompson, MM (2013) Elective Open Suprarenal Aneurysm Repair in England from 2000 to 2010 an Observational Study of Hospital Episode Statistics. PLOS ONE, 8 (5). e64163. ISSN 1932-6203 https://doi.org/10.1371/journal.pone.0064163
SGUL Authors: Hinchliffe, Robert James Holt, Peter James Edward Poloniecki, Jan Dominik Thompson, Matthew Merfyn Sollazzo, Giuseppe Vidal-Diez, Alberto

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Abstract

Background: Open surgery is widely used as a benchmark for the results of fenestrated endovascular repair of complex abdominal aortic aneurysms (AAA). However, the existing evidence stems from single-centre experiences, and may not be reproducible in wider practice. National outcomes provide valuable information regarding the safety of suprarenal aneurysm repair. Methods: Demographic and clinical data were extracted from English Hospital Episodes Statistics for patients undergoing elective suprarenal aneurysm repair from 1 April 2000 to 31 March 2010. Thirty-day mortality and five-year survival were analysed by logistic regression and Cox proportional hazards modeling. Results: 793 patients underwent surgery with 14% overall 30-day mortality, which did not improve over the study period. Independent predictors of 30-day mortality included age, renal disease and previous myocardial infarction. 5-year survival was independently reduced by age, renal disease, liver disease, chronic pulmonary disease, and known metastatic solid tumour. There was significant regional variation in both 30-day mortality and 5-year survival after risk-adjustment. Regional differences in outcome were eliminated in a sensitivity analysis for perioperative outcome, conducted by restricting analysis to survivors of the first 30 days after surgery. Conclusions: Elective suprarenal aneurysm repair was associated with considerable mortality and significant regional variation across England. These data provide a benchmark to assess the efficacy of complex endovascular repair of supra-renal aneurysms, though cautious interpretation is required due to the lack of information regarding aneurysm morphology. More detailed study is required, ideally through the mandatory submission of data to a national registry of suprarenal aneurysm repair.

Item Type: Article
Additional Information: Copyright: © 2013 Karthikesalingam et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, ABDOMINAL AORTIC-ANEURYSM, ENDOVASCULAR REPAIR, THORACOABDOMINAL ANEURYSM, ADMINISTRATIVE DATA, SURGICAL REPAIR, UNITED-STATES, MORTALITY, OUTCOMES, VOLUME, EPIDEMIOLOGY
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular & Cardiac Surgery (INCCVC)
Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: PLOS ONE
ISSN: 1932-6203
Dates:
DateEvent
23 May 2013Published
PubMed ID: 23717559
Web of Science ID: 23717559
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URI: https://openaccess.sgul.ac.uk/id/eprint/101167
Publisher's version: https://doi.org/10.1371/journal.pone.0064163

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