What is the clinical evidence from this study?

Study design: Observational. Population: Abdominal aortic aneurysm (n=10691). Intervention: Endovascular repair (EVAR) vs. Open repair. Primary outcome: 30-day mortality.

What question did this study set out to answer?

To evaluate the epidemiology, surgical trends, and perioperative mortality outcomes of abdominal aortic aneurysm (AAA) repair across Sweden over a twelve-year period.

February 25, 2008British journal of surgeryOpen Access

Outcome after abdominal aortic aneurysm repair in Sweden 1994–2005

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Key result

Open repair was independently associated with higher 30-day mortality compared to EVAR, while overall intact AAA repair incidence increased from 27.0 to 28.8 per 100,000 (P=0.006).

Why the study?

Does endovascular repair (EVAR) compared to open repair improve 30-day mortality in patients undergoing primary abdominal aortic aneurysm repair?

Population

10,691 primary abdominal aortic aneurysm repairs registered in the Swedish Vascular Registry between 1994…

Comparison

Endovascular repair (EVAR) vs Open repair

Design

Cohort

Follow-up

30-day

Authors

AWAnders WanhainenVascular Medicine NBNina BylundUppsala University MBMartin BjörckVascular Medicine

Discussion

Member takes

Implication

Supports EVAR preference over open repair for lower 30-day mortality in intact AAA; observational data leave causal benefit open for RCTs.

Key Points

To evaluate the epidemiology, surgical trends, and perioperative mortality outcomes of abdominal aortic aneurysm (AAA) repair across Sweden over a twelve-year period.
Analyzed N=10,691 primary intact and ruptured AAA repairs recorded in the Swedish Vascular Registry between 1994 and 2005.
Obtained mortality records from the national population registry and age- and sex-specific population demographics from Statistics Sweden.
Assessed time-period trends (1994–1999 vs. 2000–2005) and applied a multivariable logistic regression model to identify independent predictors of 30-day mortality.
In adults aged ≥60 years, intact AAA repair incidence increased from 27.0 to 28.8 per 100,000 (P=0.006), whereas ruptured AAA repair incidence remained stable from 13.8 to 14.1 per 100,000 (P=0.595).
Endovascular repair (EVAR) increased to 35.0% of intact and 10.3% of ruptured AAA repairs by 2005, with EVAR patients being significantly older than open repair patients (74.1 vs. 71.9 years; P<0.001).
Thirty-day mortality rates decreased over time for both intact and ruptured AAA repairs (P=0.001), with open repair, older age, and female sex independently predicting higher 30-day mortality.

Study Design

Type

Observational (n=10,691)

Multicenter

Yes

Structured PICO

Does endovascular repair (EVAR) compared to open repair improve 30-day mortality in patients undergoing primary abdominal aortic aneurysm repair?

Population

10,691 patients undergoing primary abdominal aortic aneurysm repair registered in the Swedish Vascular Registry between 1994 and 2005.

Exposure

Endovascular repair (EVAR)

Comparator

Open repair

Outcome

30-day mortality ratehard clinical

The introduction of EVAR for AAA repair in Sweden between 1994 and 2005 was associated with increased intact AAA repair rates and decreased 30-day mortality.

Cite This Study

Wanhainen et al. (2008) conducted an observational in Abdominal aortic aneurysm (n=10,691). Endovascular repair (EVAR) vs. Open repair was evaluated on 30-day mortality. Open repair was independently associated with higher 30-day mortality compared to EVAR, while overall intact AAA repair incidence increased from 27.0 to 28.8 per 100,000 (P=0.006).

synapsesocial.com/papers/6a9463fef63071196fdf33cb https://doi.org/10.1002/bjs.6109

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Implication

Supports EVAR preference over open repair for lower 30-day mortality in intact AAA; observational data leave causal benefit open for RCTs.

Outcome after abdominal aortic aneurysm repair in Sweden 1994–2005

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Outcome after abdominal aortic aneurysm repair in Sweden 1994–2005

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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