Thirty-day NSQIP database outcomes of open versus endoluminal repair of ruptured abdominal aortic aneurysms
Thirty-day NSQIP database outcomes of open versus endoluminal repair of ruptured abdominal aortic aneurysms
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DOI：
10.1016/j.jvs.2009.08.086
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发表时间：
2010-02-01
影响因子：
4.3
通讯作者：
Xenos, Eleftherios S.
中科院分区：
文献类型：
--
作者：
Davenport, Daniel L.;O'Keeffe, Shane D.;Xenos, Eleftherios S.
背景：在过去 50 年里，腹主动脉瘤破裂 (rAAA) 的死亡率每十年下降 3.5%，下降率达到 40%-50%。报告表明，血管内修复 (EVAR) 对于 rAAA 是可行的，并且可能比开放修复具有潜在的益处。我们检查了国家手术质量改进计划 (NSQIP) 数据库，比较 EVAR 与开放性 rAAA 修复的 30 天多中心结果。方法：通过结合现行程序术语 (CPT) 代码和国际疾病分类第九版修订版 (ICD-9) 诊断来识别 2005 年至 2007 年 NSQIP 数据库中接受 rAAA 修复的患者。根据变量使用 t 检验或卡方检验评估术前合并症、手术持续时间和输血以及 30 天结果。对每个结果进行单独的多变量回归，调整所有独立预测的术前和术中危险因素。结果：总共确定了 427 名患者，76.8% 的患者接受了开放式修复。开放式修复组白蛋白水平较低，术前红细胞压积 (Hct) 患者比例较高
Background: The mortality of ruptured abdominal aortic aneurysm (rAAA) has decreased 3.5% per decade in the last 50 years to a cut-rent rate of 40%-50%. Reports have indicated that endovascular repair (EVAR) is feasible for rAAA and may offer potential benefits over open repair. We examined the National Surgical Quality Improvement Program (NSQIP) database to compare 30-day multicenter outcomes for EVAR vs open rAAA repair.Methods: Patients that underwent rAAA repair in the NSQIP database from 2005 to 2007 were identified through a combination of Current Procedural Terminology (CPT) codes and International Classification of Diseases-Ninth Revision (ICD-9) diagnoses. Preoperative comorbidities, operative duration and transfusion, and 30 day outcomes were evaluated using t tests or Chi-squared tests depending on the variable. A separate multivariable regression was performed for each outcome adjusting for all independently predictive preoperative and intraoperative risk factors.Results: A total of 427 patients were identified and 76.8% of patients underwent open repair. The open repair groups exhibited lower albumin levels and higher percentage of patients with preoperative hematocrit (Hct)