Key result
In patients with abdominal aortic aneurysm, open repair was associated with worse short-term health-related quality of life compared to endovascular repair, but resulted in significant long-term improvements beyond preoperative status at two years.
Why the study?
Does EVAR improve Health Related Quality of Life compared to Open Repair in patients with Abdominal Aortic Aneurysm?
Cohort (n=76)
Open-label
None
Yes
Does EVAR improve Health Related Quality of Life compared to Open Repair in patients with Abdominal Aortic Aneurysm?
While EVAR offers better short-term quality of life compared to open repair for abdominal aortic aneurysms, open repair is associated with greater long-term improvements in health-related quality of life at two years.
Answers are grounded in this paper and cite their sources.
May inform individualized repair decisions balancing short- versus long-term quality of life; leaves open confirmation in randomized trials.
methods: Open repair (OR) or Endovascular Aortic Repair (EVAR). These two different treatments can probably result in different sense of Health related Quality of life, both in a short term and a long term perspective. The purpose of this prospective study was to examine patients’ Health related Quality of life after surgical treatment of Abdominal Aortic Aneurysm over two years using different instruments for the observations. Methods: Patients were invited consecutively to answer questionnaires before operation, and 1, 12 and 24 months after surgery. The study was conducted by using the Health related Quality of life questionnaires Short Form (SF-36) and Nottingham Health Profile (NHP). 76 patient (40 in the OR and 36 in the EVAR group) participated in the study. The mean age in the OR group were 68 years, range 52 - 80 and in the EVAR group 75 years, range 65 - 85. The results from these two groups of patients were compared to a matched reference group. Results: Patients treated with EVAR rated their Health related Quality of life significantly lower in the domain of Mental Health and Mental Component Score in relation to a matched reference population before surgery. This difference was not present two years after intervention. After one month Health related qualities of life were worse for the OR group. After two years significant improvements in relation to baseline were observed only among patients in the OR group. No such long-term benefits were seen in the EVAR group. Conclusions: As the component mental health seemed to be impaired for these study group before surgery in relation to the matched reference group, nursing and doctors care actions may be of importance during the pre-operative phase. In the short perspective Health related Quality of life is worse for OR patients than the EVAR group but in the long term perspective improvements beyond preoperative status can only be seen with OR patients.
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Pettersson et al. (2012) conducted a cohort in Abdominal Aortic Aneurysm (n=76). Open Repair (OR) vs. Endovascular Aortic Repair (EVAR) was evaluated on Health Related Quality of Life (SF-36 and NHP) at 2 years. In patients with abdominal aortic aneurysm, open repair was associated with worse short-term health-related quality of life compared to endovascular repair, but resulted in significant long-term improvements beyond preoperative status at two years.
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