Nationwide Study of Mortality After Abdominal Aortic Aneurysm Repair in France 2010- 2019

ObjectiveThe aim of this nationwide study was to analyze mortality in patients undergoing AAA repair and to explore the association between cardio-metabolic factors with clinical presentation and post-operative mortality. MethodsThis ten-year retrospective, multicenter study based on the French National electronic health data included patients undergoing AAA repair between 2010 and 2019. Post-operative mortality was analyzed using Kaplan-Meier curve survival and Log-Rank tests. A multivariate regression analysis was performed to calculate Hazard Ratios.ResultsOver 79 935 patients who underwent AAA repair, 61 146 patients (76.5%) had at least one hospital-readmission after the AAA repair, for a mean follow-up of 3.5 years +/- 2.5. The in-hospital mortality was 4 581 (5.8%) and the total post-operative mortality was 12 400 (20.3%). Age over 64 years old, the presence of AAA rupture and in-hospital readmission at 30-day were predictors of post-operative mortality (HR=1.59 CI95%=1.51 - 1.67; HR=1.49 CI95%=1.36 - 1.62 and HR=1.92, CI95%=1.84 - 2.00). Cardio-metabolic factors were negatively associated with AAA rupture (OR= 0.44 CI95%=0.41-0.47 for dyslipidemia, OR=0.75 CI95%=0.70-0.8 for hypertension). ConclusionThe negative association observed between cardio-metabolic comorbidities and AAA rupture suggests that AAA may be underdiagnosed in patients without known comorbidities and highlights the interest of AAA screening.