Key result
The occurrence of early postoperative neurological complications after EVAR or TEVAR procedures was associated with a significantly higher in-hospital mortality rate (70% vs 5.4%, p=0.001).
Why the study?
The authors aimed to present their results of EVAR/TEVAR procedures for thoracoabdominal aortic pathologies and examine the relation between post-procedural neurological adverse events and in-hospital mortality.
Does the occurrence of early postoperative neurological complications increase in-hospital mortality in patients undergoing EVAR/TEVAR?
Cohort (n=47)
No
Does the occurrence of early postoperative neurological complications increase in-hospital mortality in patients undergoing EVAR/TEVAR?
Absolute Event Rate: 70% vs 5.4%
p-value: p=0.001
The occurrence of early postoperative neurological complications after EVAR/TEVAR procedures is associated with a significantly increased risk of in-hospital mortality.
Neurological complications after EVAR/TEVAR were associated with markedly higher in-hospital mortality; leaves open whether prevention reduces risk in larger prospective cohorts.
Aim To represent our results of EVAR/TEVAR procedures for thoracoabdominal aortic pathologies and the relation between the post-procedural neurological adverse events and in-hospital mortality. Material and Method Patients who underwent EVAR/TEVAR procedures between November 2016 and May 2021 included in this retrospective study. Patients with a history of any cerebrovascular event before the intervention were excluded. Patients divided into two groups according to occurrence of any early neurological complications. Results A total of 60 patients who underwent EVAR/TEVAR procedures were evaluated. Group 1 included 37 (78.7%) patients who had no neurological complication. Group 2 included 10 (21.3%) patients who had a postoperative neurological complication. The intensive care unit stay time was significantly longer in Group 2 than Group 1 (1.7 ± 2.0 days in Group 1 vs 6.2 ± 5.1 days in Group 2, p=0.021). Overall mortality rate was 19.1% (9 of 47 patients). The mortality rate of the Group 2 was significantly higher than Group 1 (2 of 37 (5.4%) patients in Group 1 vs 7 of 10 patients (70%) in Group 2, p=0.001). American Society of Anesthesiologists physical classification score was significantly higher in Group 2 than Group 1 (3.5 ± 0.6 in Group 1 vs 4.1 ± 0.3 in Group 2, p=0.016). The most common early postoperative neurological complication was lack of recovery of consciousness (no postoperative consciousness). Conclusion The occurrence of any postoperative neurological adverse event has an additive effect to the in-hospital mortality rate of TEVAR and EVAR procedures.
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Altınay et al. (2022) conducted a cohort in Thoracoabdominal aortic pathologies (DTAA, AAA, TAA) (n=47). Early postoperative neurological complications vs. No early postoperative neurological complications was evaluated on In-hospital mortality (p=0.001). The occurrence of early postoperative neurological complications after EVAR or TEVAR procedures was associated with a significantly higher in-hospital mortality rate (70% vs 5.4%, p=0.001).
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