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Bobadilla-Rosado LO, Anaya-Ayala JE, Santos-Chavez E, Navarro J, Martinez-Quesada I, Laparra-Escareno H, Mendez-Dominguez N, Hinojosa CA. Factors that Influence Growth Rates of Abdominal Aortic Aneurysms. Analysis of a Mexican Cohort. Vasc Endovascular Surg 2024:15385744241265758. [PMID: 39034446 DOI: 10.1177/15385744241265758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
OBJECTIVE Abdominal Aortic Aneurysms (AAA) growth remains a process not fully understood. The objective of this study was to analyze risk factors associated with changes in AAA diameter in a Mexican cohort. METHODS An observational study in which we analyzed the entirely of patients in which an AAA was reported in a Computed Tomography (CT) study from 2014 to 2021 who had a follow-up CT. We divided them by groups depending on the diagnosis of type 2 diabetic mellitus and pharmacological history (diabetic vs non-diabetic, metformin vs non-metformin intake and statin vs non-statin intake). We compared pre and post follow-up AAA diameters using paired t-tests. A multivariate analysis was performed in order to identify independent variables associated with an increased growth rate. Statistical analysis was performed on Stata 17. RESULTS During the studied period 72 (39.77%) patients had a follow-up CT. Mean age was 75 years (±9.05) and 52 (72.22%) were men. When comparing infra-renal largest diameter through time based on metformin intake, a significant difference was found only in the metformin non-intake group (42.05 ± 12.54 vs45.34 ± 12.06 [P = 0.02]), in contrast the metformin intake group measures were non-significantly different (36.13 ± 7.04 vs 37.00 ± 4.51; P = 0.57) through follow-up. In the multivariate analysis AAA largest diameter at diagnosis correlated with significantly increased growth rate (coeff = 0.06, P < 0.05). CONCLUSIONS AAA diameters appear to change through time in a non-linear pattern influenced by different epidemiological and clinical factors. Metformin intake appears to promote a stability in AAA diameter growth in our studied population.
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Affiliation(s)
- Luis O Bobadilla-Rosado
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Javier E Anaya-Ayala
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Eros Santos-Chavez
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Julio Navarro
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ignacio Martinez-Quesada
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Hugo Laparra-Escareno
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Carlos A Hinojosa
- Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Franco RDL, Iora PH, Massago M, Arruda Beltrame MH, Hatoum US, Giacomin V, Borba IM, Belczak SQ, Staton CA, Dutra ADC, Andrade LD. Geographical disparities in access to surgical treatment and mortality rates from abdominal aortic aneurysms in Brazil: A retrospective longitudinal study. Vasc Med 2024:1358863X241253732. [PMID: 38860442 DOI: 10.1177/1358863x241253732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Abdominal aortic aneurysm (AAA) is a growing public health problem, and not all patients have access to surgery when needed. This study aimed to analyze spatiotemporal variations in AAA mortality and surgical procedures in Brazilian intermediate geographic regions and explore the impact of different surgical techniques on operative mortality. METHODS A retrospective longitudinal study was conducted to evaluate AAA mortality from 2008 to 2020 using space-time cube (STC) analysis and the emerging hot spot analysis tool through the Getis-Ord Gi* method. RESULTS There were 34,255 deaths due to AAA, 13,075 surgeries to repair AAA, and a surgical mortality of 14.92%. STC analysis revealed an increase in AAA mortality rates (trend statistic = +1.7693, p = 0.0769) and a significant reduction in AAA surgery rates (trend statistic = -3.8436, p = 0.0001). Analysis of emerging hotspots revealed high AAA mortality rates in the South, Southeast, and Central-West, with a reduction in procedures in São Paulo and Minas Gerais States (Southeast). In the Northeast, there were extensive areas of increasing mortality rates and decreasing procedure rates (cold spots). CONCLUSION AAA mortality increased in several regions of the country while surgery rates decreased, demonstrating the need for implementing public health policies to increase the availability of surgical procedures, particularly in less developed regions with limited access to services.
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Affiliation(s)
- Rogério do Lago Franco
- Medicine Department, State University of Maringá, Maringá, PR, Brazil
- Postgraduate Master Health Sciences Program, State University of Maringá, Maringá, PR, Brazil
| | | | - Miyoko Massago
- Postgraduate Master Health Sciences Program, State University of Maringá, Maringá, PR, Brazil
| | | | - Ualid Saleh Hatoum
- Postgraduate Master Health Sciences Program, State University of Maringá, Maringá, PR, Brazil
| | - Vinicius Giacomin
- Postgraduate Master Health Sciences Program, State University of Maringá, Maringá, PR, Brazil
| | | | | | | | | | - Luciano de Andrade
- Medicine Department, State University of Maringá, Maringá, PR, Brazil
- Postgraduate Master Health Sciences Program, State University of Maringá, Maringá, PR, Brazil
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Kim H, Kwon TW, Cho YP, Gwon JG, Han Y, Lee SA, Kim YJ, Kim S. Effects of abdominal aortic aneurysm on long-term survival in lung cancer patients. Sci Rep 2024; 14:781. [PMID: 38191895 PMCID: PMC10774350 DOI: 10.1038/s41598-023-46196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/29/2023] [Indexed: 01/10/2024] Open
Abstract
The major causes of death in patients with abdominal aortic aneurysm (AAA) are cardiovascular disease and cancer. The purpose of this study was to evaluate the effect of AAA on long-term survival in lung cancer patients. All patient data with degenerative type AAA and lung cancer over 50 years of age during the period 2009 to 2018 was collected retrospectively from a National Health Insurance Service (NHIS) administrative database and matched to lung cancer patients without AAA by age, sex, metastasis, and other comorbidities. Mortality rate was compared between the groups. A total of 956 AAA patients who could be matched with patients without AAA were included, and 3824 patients in the matched group were used for comparison. Patients with AAA showed higher risk of death compared with the matched cohort (adjusted hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.06-1.23, p < 0.001). When compared to a matched group of untreated AAA patients, patients with of history of AAA exhibited a significantly increased risk of overall mortality [HR (95%CI) 1.219 (1.113-1.335), p < .001, adjusted HR (95% CI) 1.177 (1.073-1.291), p = .001]. By contrast, mortality risk of AAA patients treated either by endovascular abdominal aortic repair or open surgical repair was not significantly different from that of the matched group (p = 0.079 and p = 0.625, respectively). The mortality risk was significantly higher when AAA was present in lung cancer patients, especially in patients with unrepaired AAA, suggesting the need for continuous cardiovascular risk management.
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Affiliation(s)
- Hyangkyoung Kim
- Department of Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
| | - Tae-Won Kwon
- Division of Vascular Surgery, Department of Surgery, College of Medicine and Asan Medical Center, University of Ulsan, Seoul, Korea.
- Department of Emergency Critical Care Trauma Surgery, Korea University Guro Hospital, 148 Gurodong-ro Guro-gu, Seoul, 08308, Korea.
- Armed Forces Trauma Center, Armed Forces Capital Hospital, Songnam, Korea.
| | - Yong-Pil Cho
- Division of Vascular Surgery, Department of Surgery, College of Medicine and Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Jun Gyo Gwon
- Division of Vascular Surgery, Department of Surgery, College of Medicine and Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Youngjin Han
- Division of Vascular Surgery, Department of Surgery, College of Medicine and Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Sang Ah Lee
- Division of Vascular Surgery, Department of Surgery, College of Medicine and Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seonok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Mulatti GC, Joviliano EE, Pereira AH, Fioranelli A, Pereira AA, Brito-Queiroz A, Von Ristow A, Freire LMD, Ferreira MMDV, Lourenço M, De Luccia N, Silveira PG, Yoshida RDA, Fidelis RJR, Boustany SM, de Araujo WJB, de Oliveira JCP. Brazilian Society for Angiology and Vascular Surgery guidelines on abdominal aortic aneurysm. J Vasc Bras 2023; 22:e20230040. [PMID: 38021279 PMCID: PMC10648059 DOI: 10.1590/1677-5449.202300402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/15/2023] [Indexed: 12/01/2023] Open
Abstract
The Brazilian Society of Angiology and Vascular Surgery, through the Guidelines Project, presents new Abdominal Aortic Aneurysm Guidelines, on the subject of care for abdominal aortic aneurysm patients. Its development prioritized descriptive guidelines, using the EMBASE, LILACS, and PubMed databases. References include randomized controlled trials, systematic reviews, meta-analyses, and cohort studies. Quality of evidence was evaluated by a pair of coordinators, aided by the RoB 2 Cochrane tool and the Newcastle Ottawa Scale forms. The subjects include juxtarenal aneurysms, infected aneurysms, and new therapeutic techniques, especially endovascular procedures. The current version of the guidelines include important recommendations for the primary topics involving diagnosis, treatment, and follow-up for abdominal aortic aneurysm patients, providing an objective guide for medical practice, based on scientific evidence and widely available throughout Brazil.
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Affiliation(s)
- Grace Carvajal Mulatti
- Universidade de São Paulo - USP, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil.
| | - Edwaldo Edner Joviliano
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto - FMRP, Ribeirão Preto, SP, Brasil.
| | - Adamastor Humberto Pereira
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre - HCPA, Porto Alegre, RS, Brasil.
| | | | - Alexandre Araújo Pereira
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre - HCPA, Porto Alegre, RS, Brasil.
| | - André Brito-Queiroz
- Universidade Federal da Bahia - UFBA, Hospital Ana Nery, Salvador, BA, Brasil.
| | - Arno Von Ristow
- Pontifícia Universidade Católica do Rio de Janeiro - PUC-Rio, Rio de Janeiro, RJ, Brasil.
| | | | | | | | - Nelson De Luccia
- Universidade de São Paulo - USP, Faculdade de Medicina, São Paulo, SP, Brasil.
| | | | - Ricardo de Alvarenga Yoshida
- Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina de Botucatu, Botucatu, SP, Brasil.
| | | | - Sharbel Mahfuz Boustany
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre - HCPA, Porto Alegre, RS, Brasil.
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Song P, He Y, Adeloye D, Zhu Y, Ye X, Yi Q, Rahimi K, Rudan I. The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modeling Analysis. Ann Surg 2023; 277:912-919. [PMID: 36177847 PMCID: PMC10174099 DOI: 10.1097/sla.0000000000005716] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAAs) in 2019 and to evaluate major associated factors. BACKGROUND Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA. METHODS PubMed, MEDLINE, and Embase were searched for articles published until October 11, 2021. Population-based studies that reported AAA prevalence in the general population, defined AAA as an aortic diameter of 30 mm or greater with ultrasonography or computed tomography. A multilevel mixed-effects meta-regression approach was used to establish the relation between age and AAA prevalence for high-demographic sociodemographic index and low-and middle-sociodemographic index countries. Odds ratios of AAA associated factors were pooled using a random-effects method. RESULTS We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30 to 79 years was 0.92% (95% CI, 0.65-1.30), translating to a total of 35.12 million (95% CI, 24.94-49.80) AAA cases in 2019. Smoking, male sex, family history of AAA, advanced age, hypertension, hypercholesterolemia, obesity, cardiovascular disease, cerebrovascular disease, claudication, peripheral artery disease, pulmonary disease, and renal disease were associated with AAA. In 2019, the Western Pacific region had the highest AAA prevalence at 1.31% (95% CI, 0.94-1.85), whereas the African region had the lowest prevalence at 0.33% (95% CI, 0.23-0.48). CONCLUSIONS A substantial proportion of people are affected by AAA. There is a need to optimize epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes.
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Affiliation(s)
- Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yazhou He
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Yuefeng Zhu
- Department of Vascular Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Vascular Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Xinxin Ye
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kazem Rahimi
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford, UK
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
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Louzada ACS, da Silva MFA, Portugal MFC, Stabellini N, Zerati AE, Amaro E, Teivelis MP, Wolosker N. Epidemiology of Abdominal Aortic Aneurysm Repair in Brazil from 2008 to 2019 and Comprehensive Review of Nationwide Statistics Across the World. World J Surg 2022; 46:1485-1492. [PMID: 35166878 DOI: 10.1007/s00268-022-06486-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Studying epidemiology of abdominal aortic aneurysms repairs is essential to prevent related deaths. Although outcomes are influenced by socioeconomic factors, there are no nationwide studies on these statistics in low-and-middle income countries. Therefore, we designed this study to evaluate abdominal aortic aneurysms repair rates, trends, costs, and in-hospital mortality in the Brazilian Public Health System, which exclusively insures over 160 million Brazilians. MATERIAL AND METHODS Retrospective cross-sectional population-based analysis of publicly available data referring to all abdominal aortic aneurysm repairs performed between 2008 and 2019 in Brazilian public hospitals. RESULTS We observed a total of 13,506 abdominal aortic aneurysm repairs, of which 32% were emergency endovascular repairs, 20% emergency open repairs, 32% elective endovascular repairs and 16% elective open repairs. There has been a downward trend in total abdominal aortic aneurysms repairs and an increasing predominance of endovascular repair. Elective and endovascular repairs were significantly associated with lower in-hospital mortality. For ruptured abdominal aortic aneurysms, we observed mortality rates of 13.8% after endovascular repair and 52.1% after open repair. For intact abdominal aortic aneurysms, we observed mortalities of 3.8% after endovascular repair and 18.6% after open repair. Procedure and mortality rates varied significantly among the Brazilian regions. CONCLUSIONS We observed a low and decreasing rate of abdominal aortic aneurysm repair. Most repairs were emergency and endovascular and there was an increasing predominance of endovascular repair. Endovascular and elective repairs were associated with lower mortality.
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Affiliation(s)
- Andressa Cristina Sposato Louzada
- Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil.
| | - Marcelo Fiorelli Alexandrino da Silva
- Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil
| | - Maria Fernanda Cassino Portugal
- Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil
| | - Nickolas Stabellini
- Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, Av. Prof. Francisco Morato, 4293, São Paulo, 05521-200, Brazil
| | - Antonio Eduardo Zerati
- Faculdade de Medicina da, Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo, 455, São Paulo, 01246-903, Brazil
| | - Edson Amaro
- Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil.,Faculdade de Medicina da, Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo, 455, São Paulo, 01246-903, Brazil
| | - Marcelo Passos Teivelis
- Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil.,Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, Av. Prof. Francisco Morato, 4293, São Paulo, 05521-200, Brazil
| | - Nelson Wolosker
- Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil.,Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, Av. Prof. Francisco Morato, 4293, São Paulo, 05521-200, Brazil.,Faculdade de Medicina da, Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo, 455, São Paulo, 01246-903, Brazil
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Preoperative Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Mean Platelet Volume as Predictors of 1-Year Mortality in Patients Undergoing an Open Repair of Abdominal Aortic Aneurysms: A Retrospective Study. J Clin Med 2021; 10:jcm10225410. [PMID: 34830692 PMCID: PMC8625427 DOI: 10.3390/jcm10225410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives: To investigate if preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), or mean platelet volume (MPV) could be used to predict 1-year mortality in patients undergoing open abdominal aortic aneurysm (AAA) repair. Methods: We retrospectively reviewed 382 patients who underwent open AAA repair between January 2008 and July 2019. We divided the patients into two groups based on 1-year mortality and compared the preoperative NLR, PLR, and MPV. The patients were then classified into tertiles based on their preoperative NLR (first tertile: <2.41 (n = 111); second tertile: 2.41 ≤ NLR ≤ 6.07 (n = 111); and third tertile: >6.07 (n = 112)). We compared the incidence of mortality and morbidity across the aforementioned tertiles. We performed a stepwise logistic regression analysis to evaluate the predictors for mortality. An additional subgroup analysis was performed by dividing the cases into non-ruptured and ruptured cases. Results: The preoperative NLR was significantly higher in the non-survivor group than in the survivor group (10.53 ± 7.60 vs. 5.76 ± 6.44, respectively, p = 0.003). The PLR and MPV were similar between the groups (145.35 ± 91.11 vs. 154.20 ± 113.19, p = 0.626, 9.38 ± 1.20 vs. 9.11 ± 1.39, p = 0.267, respectively). The incidence of 1-year mortality was 2.7%, 9.0%, and 14.3% in the first, second, and third NLR tertiles, respectively (p = 0.009). Higher NLR (odds ratio 1.085, 95% confidence interval 1.016–1.159, p = 0.015) and ruptured AAA (odds ratio 2.706, 95% confidence interval 1.097–6.673, p = 0.031) were the independent predictors of 1-year mortality in all patients. Moreover, the preoperative NLR was significantly higher in the ruptured AAA than in the non-ruptured AAA group (11.17 ± 7.90 vs. 4.10 ± 4.75, p < 0.001). In subgroup analysis, preoperative NLR (odds ratio 1.144, 95% confidence interval 1.031–1.271, p = 0.012) and PLR (odds ratio 0.986, 95% confidence interval 16 0.975–0.998, p = 0.017) was an independent predictor for 1-year mortality in ruptured cases. Conclusions: We demonstrated an independent relationship between the preoperative NLR and 1-year mortality in patients undergoing open AAA repair, besides PLR and MPV. Furthermore, the NLR and PLR had predictive power for 1-year mortality in ruptured cases.
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de Lima Naves B, Reis PEO, Ribeiro MS, de Souza LR, Oderich GS. Vascular Surgery in Brazil. Eur J Vasc Endovasc Surg 2021; 62:511-512. [PMID: 34330648 DOI: 10.1016/j.ejvs.2021.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - Paulo E O Reis
- Department of General and Specialised Surgery, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Maurício S Ribeiro
- Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Gustavo S Oderich
- Department of Cardiothoracic and Vascular Surgery, The University of Texas Health Science Centre at Houston, McGovern Medical School, Houston, TX, USA
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