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Outcomes of elective abdominal aortic aneurysm repair in the setting of malignancy.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2022 Aug; Vol. 76 (2), pp. 428-436. Date of Electronic Publication: 2022 Feb 25. - Publication Year :
- 2022
-
Abstract
- Objective: Elective abdominal aortic aneurysm (AAA) repair for patients with a diagnosis of cancer has remained controversial. In the present study, we evaluated the in-hospital outcomes for patients who had undergone AAA repair in the setting of a cancer diagnosis.<br />Methods: Inpatients (2008-2018) who had undergone elective AAA repair were selected from the Cerner Health Facts database using International Classification of Diseases, ninth and tenth revision, procedure codes. We used χ <superscript>2</superscript> analysis and logistic regression models to evaluate the association of patient characteristics with the medical and vascular outcomes.<br />Results: A total of 8663 patients who had undergone AAA repair were identified (270 with a cancer diagnosis and 8393 without a cancer diagnosis). No significant demographic differences were found between the two groups, except that more patients with a cancer diagnosis had undergone endovascular aneurysm repair (EVAR) than open aneurysm repair (88.2% vs 82.1%; P = .01). Male reproductive organ (24.8%) and lung (24.4%) cancer were the most common cancer diagnoses in the cohort. The unadjusted analysis revealed that patients with a cancer diagnosis were more likely to require remedial EVAR (relative risk, 3.47; 95% confidence interval [CI], 1.18-10.2) or reoperation for bleeding, infection, or thrombosis (relative risk, 1.59; 95% CI, 1.09-2.32). Multivariable analysis demonstrated that, overall, patients with a cancer diagnosis were more likely to require a prolonged length of stay (odds ratio [OR], 2.2; 95% CI, 1.5-3.3) and to have developed respiratory failure (OR, 2.1; 95% CI, 1.3-3.4) or infection (OR, 1.7; 95% CI, 1.2-2.4). Similar point estimates were found for men with and without a cancer diagnosis. However, women with a cancer diagnosis had a greater odds of a prolonged length of stay compared with women without a cancer diagnosis (OR, 2.6; 95% CI, 1.2-5.6). EVAR in the presence of a cancer diagnosis was also significantly associated with poor outcomes.<br />Conclusions: Elective AAA repair for patients with a cancer diagnosis was associated with a prolonged length of stay and the development of infection, respiratory failure, and vascular-specific complications during the inpatient hospitalization. Given that differences in outcomes stratified by gender and treatment modality have been shown for patients with a cancer diagnosis, careful patient selection is important and reinforces the finding that cancer exerts negative systemic postoperative effects even when treated or quiescent.<br /> (Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Elective Surgical Procedures methods
Female
Humans
Male
Postoperative Complications surgery
Postoperative Complications therapy
Retrospective Studies
Risk Factors
Treatment Outcome
Aortic Aneurysm, Abdominal diagnostic imaging
Aortic Aneurysm, Abdominal etiology
Aortic Aneurysm, Abdominal surgery
Blood Vessel Prosthesis Implantation adverse effects
Blood Vessel Prosthesis Implantation methods
Endovascular Procedures adverse effects
Neoplasms surgery
Respiratory Insufficiency etiology
Respiratory Insufficiency surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 76
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 35227798
- Full Text :
- https://doi.org/10.1016/j.jvs.2022.01.140