使用定制和现成的设备有孔腔内修复术后性别和围手术期的结果

使用定制和现成的设备有孔腔内修复术后性别和围手术期的结果
Gender and perioperative outcomes after fenestrated endovascular repair using custom-made and off-the-shelf devices

Abstract
BACKGROUND:
The role of gender on perioperative outcomes after fenestrated endovascular aortic aneurysm repair (FEVAR) has not been established. The aim of this study is to determine the effect of gender on perioperative outcomes after FEVAR for complex abdominal aortic aneurysms using premanufactured devices.
摘要
背景：
性别对有孔主动脉瘤腔内修复术后围手术期的作用（fevar）尚未建立。本研究的目的是确定性别的影响复杂腹主动脉瘤围手术期使用预制设备fevar后。

METHODS:
During a 2-year period, 79 patients (63 men [80%] and 16 women [20%]) underwent FEVAR using Zenith Fenestrated AAA Endovascular Grafts, investigational Zenith pivot branch (p-branch) devices and fenestrated custom-made devices. A single-institutional study was performed to evaluate postoperative outcomes after FEVAR. The χ2, Fisher's, and nonparametric tests were used for bivariate analysis. Logistic regression was used for multivariate analysis.
方法:
在两年的时间内，79例患者（63男16女[ 80% ]和[ 20% ]）进行fevar利用天顶开窗AAA腔内移植物，研究天顶枢支（P-分支）设备和开窗定做的设备。一个制度的研究进行评估后fevar术后结果。2的χ，Fisher，并使用非参数检验进行双变量分析。多因素分析采用逻辑回归

RESULTS:
Median age was 73 years (interquartile range [IQR], 68-79 years). The median number of fenestrations was three. There was no difference in aneurysm anatomic location, size, or number of fenestrations between patients in either group. Women were more likely to undergo endoconduits at the access site before the target procedure (19% vs 2%; P = .02). The overall postoperative complication rate was similar among females and males (31% vs 33%; P > .5). However, women experienced longer times in the intensive care unit (median, 3 days [IQR, 2-5] vs 2 [IQR, 1-3]; P = .05) and longer duration of hospital stay (median, 4.5 days [IQR, 3-6.5] vs 3 [IQR, 2-4]; P < .01). Similarly, the rate of reinterventions was higher among women, 25% vs 5% (P = .02). For renal adverse events, there was a trend for a higher rate of renal function deterioration based in creatinine levels among women, when compared with men (18% vs 5%; P = .09). Multivariate analysis showed that female gender was associated with a 8-fold increased risk of renal function deterioration (odds ratio, 8.1; 95% confidence interval, 6.1-10.8). Female gender was also identified as in independent factor for reinterventions at 30 days (odds ratio, 7.4; 95% confidence interval, 6.7-8.1).
结果:
年龄中位数为73年（四分位距[IQR]，68-79年）。开窗的中位数为三。在动脉瘤的解剖位置、大小没有明显差异，或多开窗两组患者之间。妇女更可能发生在目标程序访问网站endoconduits（19% vs 2%；P = 02）。女性和男性的术后并发症发生率相似（31%比33%，P＞5）。然而，女性经历了较长的时间，在ICU（中位数3天[为2-5 ] vs 2 [为1-3 ]；P = 05）和住院时间较长（平均4.5天[为3-6.5 ] vs 3 [ 2-4 ]为；P <0。01）。同样，再处理率较高的女性中，25%和5%（P = 02）。对于肾性不良事件，有一个趋势，一个更高的肾功能恶化的妇女，当与男性相比，肌酐水平（18%比5%，P = 09）。多因素分析表明，性别是一个8倍增加肾功能恶化风险相关（比值比，8.1；95%置信区间，6.1-10.8）。女性也被确定为独立的因素，再在30天（比值比，7.4；95%置信区间，6.7-8.1）。

CONCLUSIONS:
FEVAR is a safe and effective procedure for patients at high and standard risk for open repair who are not eligible for standard EVAR. Women are at greater risk for more severe renal function deterioration, early reinterventions and longer durations of hospital and intensive care unit stay.
结论：
是一种安全、有效的fevar开放修复那些不符合标准的高风险患者EVAR和标准程序。女性在更严重的肾功能恶化的风险更大，早期的再处理和持续时间较长的医院和ICU停留。

英文全文：
Gender and perioperative outcomes after fenestrated endovascular repair using cu.pdf (240.09 KB, 下载次数: 0, 售价: 99 香叶)

2016-10-9 09:11 上传

点击文件名下载附件
使用定制和现成的设备有孔腔内修复术后性别和围手术期的结果