Patterson, BO; Vidal-Diez, A; Holt, PJ; Scali, ST; Beck, AW; Thompson, MM
(2016)
Predicting Mid-term All-cause Mortality in Patients Undergoing Elective Endovascular Repair of a Descending Thoracic Aortic Aneurysm.
Annals of Surgery, 264 (6).
pp. 1162-1167.
ISSN 1528-1140
https://doi.org/10.1097/SLA.0000000000001577
SGUL Authors: Holt, Peter James Edward Thompson, Matthew Merfyn Vidal-Diez, Alberto Patterson, Benjamin Oliver
|
PDF (Main text)
Accepted Version
Download (82kB) | Preview |
|
|
PDF (Supplemental material)
Accepted Version
Download (203kB) | Preview |
|
|
PDF (Table 1)
Accepted Version
Download (8kB) | Preview |
Abstract
INTRODUCTION: All-cause mortality in patients after repair of aortic aneurysms of the descending thoracic aorta thoracic endovascular aortic repair (TEVAR) is relatively high at mid-term follow-up. The aim of this study was to derive and validate a system that could predict all-cause mortality after TEVAR to aid with patient selection. METHODS: The MOTHER database contained 625 patients that underwent elective surgery for descending thoracic aortic aneurysms. Univariate analysis identified preoperative factors associated with mid-term all-cause mortality, and a Cox proportional hazards model was developed. The model was internally validated using Kaplan-Meier comparison of observed vs predicted mortality. External validation was performed using a data set from the University of Florida College of Medicine. RESULTS: There were 625 patients that underwent TEVAR for descending thoracic aortic aneurysm in the MOTHER database and 231 in the University of Florida College of Medicine validation set. The mid-term mortality rate at 6 years of follow-up was 34.4% and 34%, respectively. The all-cause mortality risk score was calculated using 0.0398 × (age) + 0.516 × (renal insufficiency) + 0.46 × (previous cerebrovascular disease) + 0.352 × (prior tobacco use) + 0.376 × (number of devices >2) + 0.016 × (maximum aneurysm diameter). Using this score, low-, medium-, and high-risk groups were defined, with predicted survival at 5 years of 80%, 60%, and 40%. Patients at high risk of mid-term all-cause death were identified in the validation cohort using the prediction rule. CONCLUSIONS: Identifying patients with a limited life expectancy after TEVAR is possible using a preoperative risk-stratification system. This information can be used to inform decision making regarding when and whether to proceed with TEVAR.
Item Type: | Article | ||||||
---|---|---|---|---|---|---|---|
Additional Information: | Please refer to publisher version for figures. This is a non-final version of an article published in final form in: Patterson, BO; Vidal-Diez, A; Holt, PJ; Scali, ST; Beck, AW; Thompson, MM (2016) Predicting Mid-term All-cause Mortality in Patients Undergoing Elective Endovascular Repair of a Descending Thoracic Aortic Aneurysm. Annals of Surgery, 264 (6). pp. 1162-1167. ISSN 1528-1140 10.1097/SLA.0000000000001577 | ||||||
Keywords: | aortic disease, endovascular surgery, mortality, outcomes, risk stratification, Surgery, 11 Medical And Health Sciences | ||||||
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: | Annals of Surgery | ||||||
ISSN: | 1528-1140 | ||||||
Language: | eng | ||||||
Projects: |
|
||||||
PubMed ID: | 26813915 | ||||||
Web of Science ID: | WOS:000387978500048 | ||||||
Go to PubMed abstract | |||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/107699 | ||||||
Publisher's version: | https://doi.org/10.1097/SLA.0000000000001577 |
Statistics
Actions (login required)
![]() |
Edit Item |