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Preoperative Spirometry Results as a Determinant for Long-term Mortality after EVAR for AAA

Ohrlander, T.; Dencker, Magnus LU and Acosta, S. (2012) In European Journal of Vascular and Endovascular Surgery 43(1). p.43-47
Abstract
Objectives: The aim of this study was to analyse lung function test determinants for long-term mortality after standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Design: Retrospective analysis. Materials: Three-hundred and four consecutive patients treated electively with EVAR (Zenith (R) stent grafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerised database. Methods: The Global Initiative for Chronic Obstructive Lung Diseases (GOLD) guideline was used to grade the severity of obstructive lung disease. Mortality was checked until 1 December 2010. Median follow-up time was 68 (interquartile range (IQR) 40-94) months. Results: The percentage of patients with... (More)
Objectives: The aim of this study was to analyse lung function test determinants for long-term mortality after standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Design: Retrospective analysis. Materials: Three-hundred and four consecutive patients treated electively with EVAR (Zenith (R) stent grafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerised database. Methods: The Global Initiative for Chronic Obstructive Lung Diseases (GOLD) guideline was used to grade the severity of obstructive lung disease. Mortality was checked until 1 December 2010. Median follow-up time was 68 (interquartile range (IQR) 40-94) months. Results: The percentage of patients with mild, moderate or severe (grade 3) chronic obstructive pulmonary disease (COPD) was 9.9%, 23.2% and 7.7%, respectively. In a combined medical severity assessment, arterial partial pressure of oxygen (PaO2) < 8.0 kPa or COPD, grade >= 3 (hazard ratio (HR) 2.06; 95% confidence interval (CI) (1.24-3.42)), anaemia (HR 1.72; 95% CI (1.21-2.44)), chronic kidney disease, stage >= 3 (HR 1.55; 95% Cl (1.08-2.24)) and age >= 80 years (HR 1.55; 95% Cl (1.04-2.31)) were independently associated with long-term mortality. Lower forced expiratory volume in 1 s (FEV1) (p = 0.002) and lower forced vital capacity (FVC) (p = 0.003) were independently associated with long-term mortality. Conclusions: Our findings strengthen the need for formal evaluation of lung function with spirometry prior to proceeding to AAA repair. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
EVAR, Lung function, Spirometry, Arterial blood gas, Mortality
in
European Journal of Vascular and Endovascular Surgery
volume
43
issue
1
pages
43 - 47
publisher
Elsevier
external identifiers
  • wos:000299609000012
  • scopus:83655184789
ISSN
1532-2165
DOI
10.1016/j.ejvs.2011.09.028
language
English
LU publication?
yes
id
0c33d8ea-b035-4b01-99e8-c1c924cf79a9 (old id 2425517)
date added to LUP
2012-04-02 09:52:02
date last changed
2017-07-30 04:03:55
@article{0c33d8ea-b035-4b01-99e8-c1c924cf79a9,
  abstract     = {Objectives: The aim of this study was to analyse lung function test determinants for long-term mortality after standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Design: Retrospective analysis. Materials: Three-hundred and four consecutive patients treated electively with EVAR (Zenith (R) stent grafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerised database. Methods: The Global Initiative for Chronic Obstructive Lung Diseases (GOLD) guideline was used to grade the severity of obstructive lung disease. Mortality was checked until 1 December 2010. Median follow-up time was 68 (interquartile range (IQR) 40-94) months. Results: The percentage of patients with mild, moderate or severe (grade 3) chronic obstructive pulmonary disease (COPD) was 9.9%, 23.2% and 7.7%, respectively. In a combined medical severity assessment, arterial partial pressure of oxygen (PaO2) &lt; 8.0 kPa or COPD, grade &gt;= 3 (hazard ratio (HR) 2.06; 95% confidence interval (CI) (1.24-3.42)), anaemia (HR 1.72; 95% CI (1.21-2.44)), chronic kidney disease, stage &gt;= 3 (HR 1.55; 95% Cl (1.08-2.24)) and age &gt;= 80 years (HR 1.55; 95% Cl (1.04-2.31)) were independently associated with long-term mortality. Lower forced expiratory volume in 1 s (FEV1) (p = 0.002) and lower forced vital capacity (FVC) (p = 0.003) were independently associated with long-term mortality. Conclusions: Our findings strengthen the need for formal evaluation of lung function with spirometry prior to proceeding to AAA repair. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.},
  author       = {Ohrlander, T. and Dencker, Magnus and Acosta, S.},
  issn         = {1532-2165},
  keyword      = {EVAR,Lung function,Spirometry,Arterial blood gas,Mortality},
  language     = {eng},
  number       = {1},
  pages        = {43--47},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {Preoperative Spirometry Results as a Determinant for Long-term Mortality after EVAR for AAA},
  url          = {http://dx.doi.org/10.1016/j.ejvs.2011.09.028},
  volume       = {43},
  year         = {2012},
}