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Influence of preoperative medical assessment prior to elective endovascular aneurysm repair for abdominal aortic aneurysm

Ohrlander, T.; Nessvi, Sofia LU ; Gottsäter, Anders LU ; Dencker, Magnus LU and Acosta, Stefan LU (2012) In International Angiology 31(4). p.368-375
Abstract
Aim. The aim of this study was to compare preoperative patient evaluation by a vascular physician with a standardized workup protocol prior to elective endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), in terms of differences in patient medication and mortality. Methods. Consecutive patients with infrarenal AAA treated with standard EVAR from 1998 to 2006 (group 2) and 2007 to 2011 (group 1) were compared. Patients in group 1 (N.=201) were investigated preoperatively by a vascular physician, evaluating comorbidities and medication. Patients in group 2 (N.=304) underwent a standardized preoperative work-up including spirometry and echocardiography. Median time of follow-up was 23 months in group 1 and 71 months in... (More)
Aim. The aim of this study was to compare preoperative patient evaluation by a vascular physician with a standardized workup protocol prior to elective endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), in terms of differences in patient medication and mortality. Methods. Consecutive patients with infrarenal AAA treated with standard EVAR from 1998 to 2006 (group 2) and 2007 to 2011 (group 1) were compared. Patients in group 1 (N.=201) were investigated preoperatively by a vascular physician, evaluating comorbidities and medication. Patients in group 2 (N.=304) underwent a standardized preoperative work-up including spirometry and echocardiography. Median time of follow-up was 23 months in group 1 and 71 months in group 2. Results. The proportion of patients who had on-going medication with anti-platelet and lipid lowering medication at admission was higher in group 1 compared to group 2 (62% versus 51%; P=0.013 and 68% versus 35%; P<0.001). In group 1, the proportion of newly instituted or increased dosage of anti-hypertensive, anti-platelet or lipid lowering medication at preoperative evaluation was 40%, 24% and 31%, respectively. The total cost for preoperative assessment per patient was 272 (sic) in group 1 and 293 (sic) in group 2 (P<0.001). There was no difference in 30-day (P=0.29) or long-term (P.0.24) mortality between the two groups. Conclusion. Preoperative assessment by a vascular physician resulted in lower costs and improvement of medication against atherosclerosis, uncontrolled hypertension and perioperative ischemic cardiac events, but mortality was unaffected. [Int Angiol 2012;31:368-75] (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atherosclerosis, abdominal, Aortic aneurysm, Endovascular procedures
in
International Angiology
volume
31
issue
4
pages
368 - 375
publisher
Minerva Medica
external identifiers
  • wos:000309443800009
  • scopus:84867616456
ISSN
1827-1839
language
English
LU publication?
yes
id
1b83d5df-aa37-46b8-bc17-79ee426d155b (old id 3188121)
date added to LUP
2012-12-03 06:57:34
date last changed
2017-01-01 04:03:18
@article{1b83d5df-aa37-46b8-bc17-79ee426d155b,
  abstract     = {Aim. The aim of this study was to compare preoperative patient evaluation by a vascular physician with a standardized workup protocol prior to elective endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), in terms of differences in patient medication and mortality. Methods. Consecutive patients with infrarenal AAA treated with standard EVAR from 1998 to 2006 (group 2) and 2007 to 2011 (group 1) were compared. Patients in group 1 (N.=201) were investigated preoperatively by a vascular physician, evaluating comorbidities and medication. Patients in group 2 (N.=304) underwent a standardized preoperative work-up including spirometry and echocardiography. Median time of follow-up was 23 months in group 1 and 71 months in group 2. Results. The proportion of patients who had on-going medication with anti-platelet and lipid lowering medication at admission was higher in group 1 compared to group 2 (62% versus 51%; P=0.013 and 68% versus 35%; P&lt;0.001). In group 1, the proportion of newly instituted or increased dosage of anti-hypertensive, anti-platelet or lipid lowering medication at preoperative evaluation was 40%, 24% and 31%, respectively. The total cost for preoperative assessment per patient was 272 (sic) in group 1 and 293 (sic) in group 2 (P&lt;0.001). There was no difference in 30-day (P=0.29) or long-term (P.0.24) mortality between the two groups. Conclusion. Preoperative assessment by a vascular physician resulted in lower costs and improvement of medication against atherosclerosis, uncontrolled hypertension and perioperative ischemic cardiac events, but mortality was unaffected. [Int Angiol 2012;31:368-75]},
  author       = {Ohrlander, T. and Nessvi, Sofia and Gottsäter, Anders and Dencker, Magnus and Acosta, Stefan},
  issn         = {1827-1839},
  keyword      = {Atherosclerosis,abdominal,Aortic aneurysm,Endovascular procedures},
  language     = {eng},
  number       = {4},
  pages        = {368--375},
  publisher    = {Minerva Medica},
  series       = {International Angiology},
  title        = {Influence of preoperative medical assessment prior to elective endovascular aneurysm repair for abdominal aortic aneurysm},
  volume       = {31},
  year         = {2012},
}