Treatment Outcome Trends for Non-Ruptured Abdominal Aortic Aneurysms: A Nationwide Prospective Cohort Study. (February 2022)

• Record Type: Journal Article
• Authors: Alberga, Anna J.; Karthaus, Eleonora G.; Wilschut, Janneke A.; de Bruin, Jorg L.; Akkersdijk, George P.; Geelkerken, Robert H.; Hamming, Jaap F.; Wever, Jan J.; Verhagen, Hence J.M.; van den Akker, P.J.; Akkersdijk, G.P.; Akkersdijk, W.L.; van Andringa de Kempenaer, M.G.; Arts, C.H.P.; Avontuur, A.M.; Bakker, O.J.; Balm, R.; Barendregt, W.B.; Bekken, J.A.; Bender, M.H.M.; Bendermacher, B.L.W.; van den Berg, M.; Beuk, R.J.; Blankensteijn, J.D.; Bode, A.S.; Bodegom, M.E.; van der Bogt, K.E.A.; Boll, A.P.M.; Booster, M.H.; Borger van der Burg, B.L.S.; de Borst, G.J.; Bos-van Rossum, W.T.G.J.; Bosma, J.; Botman, J.M.J.; Bouwman, L.H.; Brehm, V.; de Bruijn, M.T.; de Bruin, J.L.; Brummel, P.; van Brussel, J.P.; Buijk, S.E.; Buimer, M.G.; Buscher, H.C.J.L.; Cancrinus, E.; Castenmiller, P.H.; Cazander, G.; Cuypers, P.h.W.M.; Daemen, J.H.C.; Dawson, I.; Dierikx, J.E.; Dijkstra, M.L.; Diks, J.; Dinkelman, M.K.; Dirven, M.; Dolmans, D.E.J.G.J.; van Dortmont, L.M.C.; Drouven, J.W.; van der Eb, M.M.; Eefting, D.; van Eijck, G.J.W.M.; Elshof, J.W.M.; Elsman, B.H.P.; van der Elst, A.; van Engeland, M.I.A.; van Eps, G.S.; Faber, M.J.; de Fijter, W.M.; Fioole, B.; Fritschy, W.M.; Jin, P.H.P.F.K.; Geelkerken, R.H.; van Gent, W.B.; Glade, G.J.; Govaert, B.; Groenendijk, R.P.R.; de Groot, H.G.W.; van den Haak, R.F.F.; de Haan, E.F.A.; Hajer, G.F.; Hamming, J.F.; van Hattum, E.S.; Hazenberg, C.E.V.B.; Hedeman Joosten, P.P.h.A.; Helleman, J.N.; van der Hem, L.G.; Hendriks, J.M.; van Herwaarden, J.A.; Heyligers, J.M.M.; Hinnen, J.W.; Hissink, R.J.; Ho, G.H.; den Hoed, P.T.; Hoedt, M.T.C.; van Hoek, F.; Hoencamp, R.; Hoffmann, W.H.; Hoksbergen, A.W.J.; Hollander, E.J.F.; Huisman, L.C.; Hulsebos, R.G.; Huntjens, K.M.B.; Idu, M.M.; Jacobs, M.J.H.M.; van der Jagt, M.F.P.; Jansbeken, J.R.H.; Janssen, R.J.L.; Jiang, H.H.L.; de Jong, S.C.; Jongbloed-Winkel, T.A.; Jongkind, V.; Kapma, M.R.; Keller, B.P.J.A.; Jahrome, A.K.; Kievit, J.K.; Klemm, P.L.; Klinkert jr, P.; Koedam, N.A.; Koelemaij, M.J.W.; Kolkert, J.L.P.; Koning, G.G.; Koning, O.H.J.; Konings, R.; Krasznai, A.G.; Kropman, R.H.J.; Kruse, R.R.; van der Laan, L.; van der Laan, M.J.; van Laanen, J.H.H.; van Lammeren, G.W.; Lamprou, D.A.A.; Lardenoije, J.H.P.; Lauret, G.J.; Leenders, B.J.M.; Legemate, D.A.; Leijdekkers, V.J.; Lemson, M.S.; Lensvelt, M.M.A.; Lijkwan, M.A.; van der Linden, F.T.h.P.M.; Lung, P.F. Liqui; Loos, M.J.A.; Loubert, M.C.; van de Luijtgaarden, K.M.; Mahmoud, D.E.A.K.; Manshanden, C.G.; Mattens, E.C.J.L.; Meerwaldt, R.; Mees, B.M.E.; Menting, T.P.; Metz, R.; de Mol van Otterloo, J.C.A.; Molegraaf, M.J.; Montauban van Swijndregt, Y.C.A.; Morak, M.J.M.; van de Mortel, R.H.W.; Mulder, W.; Nagesser, S.K.; Naves, C.C.L.M.; Nederhoed, J.H.; Nevenzel, A.M.; de Nie, A.J.; Nieuwenhuis, D.H.; van Nieuwenhuizen, R.C.; Nieuwenhuizen, J.; Nio, D.; Oomen, A.P.A.; Oranen, B.I.; Oskam, J.; Palamba, H.W.; Peppelenbosch, A.G.; van Petersen, A.S.; Petri, B.J.; Pierie, M.E.N.; Ploeg, A.J.; Pol, R.A.; Ponfoort, E.D.; Poyck, P.P.C.; Prent, A.; Raa, S. ten; Raymakers, J.T.F.J.; Reichmann, B.L.; Reijnen, M.M.P.J.; de Ridder, J.A.M.; Rijbroek, A.; van Rijn, M.J.E.; de Roo, R.A.; Rouwet, E.V.; Saleem, B.R.; van Sambeek, M.R.H.M.; Samyn, M.G.; van 't Sant, H.P.; van Schaik, J.; van Schaik, P.M.; Scharn, D.M.; Scheltinga, M.R.M.; Schepers, A.; Schlejen, P.M.; Schlösser, F.J.V.; Schol, F.P.G.; Scholtes, V.P.W.; Schouten, O.; Schreve, M.A.; Schurink, G.W.H.; Sikkink, C.J.J.M.; Slaa, A. te; Smeets, H.J.; Smeets, L.; Smeets, R.R.; de Smet, A.A.E.A.; Smit, P.C.; Smits, T.M.; Snoeijs, M.G.J.; Sondakh, A.O.; Speijers, M.J.; van der Steenhoven, T.J.; van Sterkenburg, S.M.M.; Stigter, D.A.A.; Stokmans, R.A.; Strating, R.P.; Stultiëns, G.N.M.; Sybrandy, J.E.M.; Teijink, J.A.W.; Telgenkamp, B.J.; Testroote, M.J.G.; Tha-In, T.; The, R.M.; Thijsse, W.J.; Thomassen, I.; Tielliu, I.F.J.; van Tongeren, R.B.M.; Toorop, R.J.; Tournoij, E.; Truijers, M.; Türkcan, K.; Tutein Nolthenius, R.P.; Ünlü, C.; Vaes, R.H.D.; Vahl, A.C.; Veen, E.J.; Veger, H.T.C.; Veldman, M.G.; Verhagen, H.J.M.; Verhoeven, B.A.N.; Vermeulen, C.F.W.; Vermeulen, E.G.J.; Vierhout, B.P.; van der Vijver-Coppen, R.J.; Visser, M.J.T.; van der Vliet, J.A.; van Vlijmen - van Keulen, C.J.; van der Vorst, J.R.; Vos, A.W.F.; Vos, C.G.; Vos, G.A.; de Vos, B.; Voûte, M.T.; Vriens, B.H.R.; Vriens, P.W.H.E.; de Vries, D.K.; de Vries, J.P.P.M.; de Vries, M.; de Vries, A.C.; van der Waal, C.; Waasdorp, E.J.; Wallis de Vries, B.M.; van Walraven, L.A.; van Wanroi, J.L.; Warlé, M.C.; van Weel, V.; van Well, A.M.E.; Welten, G.M.J.M.; Wever, J.J.; Wiersema, A.M.; Wikkeling, O.R.M.; Willaert, W.I.M.; Wille, J.; Willems, M.C.M.; Willigendael, E.M.; Wilschut, E.D.; Wisselink, W.; Witte, M.E.; Wittens, C.H.A.; Wong, C.Y.; Yazar, O.; Yeung, K.K.; Zeebregts, C.J.A.M.; van Zeeland, M.L.P.;
• Is Part Of: European journal of vascular and endovascular surgery. Volume 63:Number 2(2022)
• Page Start: 275
• Page End: 283
• Publication Date: 2022-02
• Subjects: Abdominal aortic aneurysm -- Endovascular procedure -- Operative procedure -- Quality of care -- Treatment outcome -- Trends; Blood-vessels -- Endoscopic surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; Blood-vessels -- Endoscopic surgery; Blood-vessels -- Surgery; Endoscopy; Electronic journals; Periodicals; Electronic journals; 617.413005
• DOI: 10.1016/j.ejvs.2021.08.019
• Languages: English
• ISSNs: 1078-5884

Abstract

Abstract : Objective: The Dutch Surgical Aneurysm Audit (DSAA) initiative was established in 2013 to monitor and improve nationwide outcomes of aortic aneurysm surgery. The objective of this study was to examine whether outcomes of surgery for intact abdominal aortic aneurysms (iAAA) have improved over time. Methods: Patients who underwent primary repair of an iAAA by standard endovascular (EVAR) or open surgical repair (OSR) between 2014 and 2019 were selected from the DSAA for inclusion. The primary outcome was peri-operative mortality trend per year, stratified by OSR and EVAR. Secondary outcomes were trends per year in major complications, textbook outcome (TbO), and characteristics of treated patients. The trends per year were evaluated and reported in odds ratios per year. Results: In this study, 11 624 patients (74.8%) underwent EVAR and 3 908 patients (25.2%) underwent OSR. For EVAR, after adjustment for confounding factors, there was no improvement in peri-operative mortality (aOR [adjusted odds ratio] 1.06, 95% CI 0.94 – 1.20), while major complications decreased (2014: 10.1%, 2019: 7.0%; aOR 0.91, 95% CI 0.88 – 0.95) and the TbO rate increased (2014: 68.1%, 2019: 80.9%; aOR 1.13, 95% CI 1.10 – 1.16). For OSR, the peri-operative mortality decreased (2014: 6.1%, 2019: 4.6%; aOR 0.89, 95% CI 0.82 – 0.98), as well as major complications (2014: 28.6%, 2019: 23.3%; aOR 0.95, 95% CI 0.91 – 0.99). Furthermore, the proportion of TbO increased (2014: 49.1%, 2019: 58.3%; aOR 1.05, 95% CI 1.01 – 1.10). In both the EVAR and OSR group, the proportion of patients with cardiac comorbidity increased. Conclusion: Since the establishment of this nationwide quality improvement initiative (DSAA), all outcomes of iAAA repair following EVAR and OSR have improved, except for peri-operative mortality following EVAR which remained unchanged.