Sex-specific differences in the standard of care for infrarenal abdominal aortic aneurysm repair, and risk of major adverse cardiovascular events and death

Figures

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  Fig. 1. Percentage of men and women undergoing elective infrarenal abdominal aortic aneurysm repair, treated according to standard of care a Preoperative assessment, b treatment within waiting time standards, c cardiovascular risk prevention, and d perioperative medications (antibiotic and deep venous thrombosis prophylaxis). OAR, open aortic repair; EVAR, endovascular aortic repair. *P < 0.010, †P < 0.001 (Chi-square test).

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  Fig. 2. Percentage of men and women experiencing a perioperative major adverse cardiovascular event or death after infrarenal abdominal aortic aneurysm repair a Open and b endovascular aortic repair. MACED, major adverse cardiovascular event or death; MACE, major adverse cardiovascular event. *P < 0.001 (Chi-square test).

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  Fig. 3. Sex-specific odds of major adverse cardiovascular event or death Unadjusted odds for women are shown, followed by those for forwards stepwise models adjusting for age (≥ 75 years), repair type (endovascular repair), sociodemographic factors (UK deprivation quintile and smoking status), co-morbid status (ischaemic heart disease, congestive heart failure, peripheral arterial disease, chronic kidney disease, stroke, cancer, hypoalbuminaemia (below 35 g/dl), anaemia (less than 13 g/dl for men and less than12 g/dl for women), abnormal ECG, ASA grade), medications (anticoagulation, beta-blocker, and statin), preoperative standard of care (preoperative assessment, treatment within waiting time targets, cardiovascular risk prevention, need for medication adjustment, and specialty referral), and abdominal aortic aneurysm (AAA) repair factors (aortic size index, symptomatic status, and general anaesthetic), and for the optimal logistic regression model selected by backwards selection. ORs are shown with 95% confidence intervals. MACED, major adverse cardiovascular event or death.

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  Fig. 4. Optimal logistic regression model obtained by backwards selection ORs are shown with 95% confidence intervals. Reference categories: ASA I, deprivation quintile 1. COPD, chronic obstructive pulmonary disease; EVAR, endovascular aortic repair; SOC, standard of care; MACED, major adverse cardiovascular event or death.

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  Fig. 5. Sex-specific reduction in odds of major adverse cardiovascular event or death associated with standard of care a Standard-of-care (SOC) preoperative assessment and b SOC waiting times. ORs are shown with 95% confidence intervals. MACED, major adverse cardiovascular event or death.