• Br J Surg · Mar 2022

    Mortality following elective abdominal aortic aneurysm repair in women.

    • V N Tedjawirja, A J Alberga, M H P Hof, A C Vahl, KoelemayM J WMJWDepartment of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., R Balm, and Dutch Society of Vascular Surgery.
    • Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
    • Br J Surg. 2022 Mar 15; 109 (4): 340345340-345.

    BackgroundPrevious studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women.MethodsPatients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR).ResultsSome 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase).ConclusionWomen are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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