Simulations of the effects of scheduled abdominal aortic aneurysm repair on survival.
Simulations of the effects of scheduled abdominal aortic aneurysm repair on survival.
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DOI：
10.1111/anae.13107
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发表时间：
2015-06
期刊：
影响因子：
10.7
通讯作者：
Carlisle JB
中科院分区：
文献类型：
--
作者：
Carlisle JB
我模拟了不同人群中不同直径的腹主动脉瘤在有无计划修复的情况下的存活率。结果表明，计划的修复应该结合患者每月的死亡风险和动脉瘤直径来确定。一些患者的中位生存期将通过对小于55 mm的动脉瘤的定期修复而延长，而另一些患者的中位生存期将因任何动脉瘤的修复而缩短。结果还表明，平均而言，监测是徒劳的：动脉瘤修复计划对个人中位存活率的影响没有改变，但随着患者在监测期间死亡，队列效应减弱。英国小动脉瘤研究的结果在模拟中重现，并与直径小于55 mm的动脉瘤的修复相兼容。流行病学模拟表明，过去的随机对照试验低估了今天动脉瘤修复的效果。
I simulated survival with and without scheduled repair of abdominal aortic aneurysms with different diameters in different populations. The results imply that scheduled repair should be determined by the combination of a patient's monthly mortality hazard and aneurysm diameter. The median survival of some patients will be extended by the scheduled repair of aneurysms smaller than 55 mm, whereas the median survival of other patients will be curtailed by repair of any aneurysm. The results also suggest that, on average, surveillance is futile: the effect of scheduled aneurysm repair on an individual's median survival did not change but the cohort effect diminished as patients died during surveillance. The results of the UK Small Aneurysm Study were reproduced in simulation and are compatible with the repair of aneurysms smaller than 55 mm diameter. Epidemiological simulations suggest that past randomised controlled trials underestimate the effect of aneurysm repair today.
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