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. 2022 Mar 15;109(4):340-345.
doi: 10.1093/bjs/znab465.

Mortality following elective abdominal aortic aneurysm repair in women

V N Tedjawirja  1 , A J Alberga  2   3 , M H P Hof  4 , A C Vahl  5 , M J W Koelemay  1 , R Balm  1 ; Dutch Society of Vascular Surgery
Collaborators, Affiliations

Mortality following elective abdominal aortic aneurysm repair in women

V N Tedjawirja et al. Br J Surg. .

Abstract

Background: Previous 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.

Methods: Patients 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).

Results: Some 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).

Conclusion: Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.

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Figures

Fig. 1
Fig. 1
Study flow diagram
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