Long Term Quality of Life, Health Status, and Residential Destination after Emergency Abdominal Aortic Aneurysm Repair.

IF 5.7 1区医学 Q1 PERIPHERAL VASCULAR DISEASE European Journal of Vascular and Endovascular Surgery Pub Date : 2024-11-11 DOI:10.1016/j.ejvs.2024.11.002

Tijmen F C M Nederstigt, Daphne van der Veen, Jan-Willem Lardenoije, Michel Reijnen

{"title":"Long Term Quality of Life, Health Status, and Residential Destination after Emergency Abdominal Aortic Aneurysm Repair.","authors":"Tijmen F C M Nederstigt, Daphne van der Veen, Jan-Willem Lardenoije, Michel Reijnen","doi":"10.1016/j.ejvs.2024.11.002","DOIUrl":null,"url":null,"abstract":"Objective: This retrospective, multicentre, observational cohort study aimed to assess the long term quality of life, health status, and residential destination after successful treatment of a ruptured abdominal aortic aneurysm (rAAA) treated with endovascular aneurysm repair (EVAR) or open surgical repair (OSR).Methods: Consecutive patients from five large teaching hospitals with a computed tomography confirmed rAAA from 1 January 2013 to 31 December 2018 were included. Mortality, morbidity, discharge destination, and residential destination through follow up were registered. Quality of life (QoL) was measured with the World Health Organization Quality of Life BREF questionnaire, and health status with the 5 Level EuroQoL 5 Dimension (EQ-5D-5L) questionnaire. Subgroup analyses were performed between OSR and EVAR, and age < 80 years and ≥ 80 years (octogenarians).Results: A total of 349 patients were enrolled: 168 (48.1%) were treated with EVAR. The overall 30 day, one year, and five year survival rates were 74.2% 66.0%, and 45.0%, respectively. At follow up (59.5 ± 2.1 months), the residential destination was home for 46.7% of patients. Of the patients, 48% were treated with EVAR and 49.6% with OSR (p = .48). More patients aged < 80 years (55.9%) where living at home (p < .001) at follow up. The mean QoL subscore for environment was 16.4 ± 2.1, physical health 14.5 ± 3.0, psychological health 15.5 ± 2.3, and social relationships 15.0 ± 2.6. Analyses of treatment modalities showed no statistically significant differences. Patients aged < 80 years had a higher mean physical health subscore (14.8 ± 2.8; p = .015). The median health score on the EQ-5D-5L was 72.3 ± 19.2. No difference was found between treatments. Daily activities favoured the younger cohort (p = .019).Conclusion: There was no difference regarding QoL and last residential destination in both treatment arms over the long term. Both EVAR and OSR are justified in treating rAAA. Age alone should not be a decisive argument, but elderly patients have a lower likelihood of return to their home situation. Patients should be informed that if they survive the peri-operative period, the chances are that they will experience life comparable with the general elderly population living at home.","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Vascular and Endovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ejvs.2024.11.002","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This retrospective, multicentre, observational cohort study aimed to assess the long term quality of life, health status, and residential destination after successful treatment of a ruptured abdominal aortic aneurysm (rAAA) treated with endovascular aneurysm repair (EVAR) or open surgical repair (OSR).

Methods: Consecutive patients from five large teaching hospitals with a computed tomography confirmed rAAA from 1 January 2013 to 31 December 2018 were included. Mortality, morbidity, discharge destination, and residential destination through follow up were registered. Quality of life (QoL) was measured with the World Health Organization Quality of Life BREF questionnaire, and health status with the 5 Level EuroQoL 5 Dimension (EQ-5D-5L) questionnaire. Subgroup analyses were performed between OSR and EVAR, and age < 80 years and ≥ 80 years (octogenarians).

Results: A total of 349 patients were enrolled: 168 (48.1%) were treated with EVAR. The overall 30 day, one year, and five year survival rates were 74.2% 66.0%, and 45.0%, respectively. At follow up (59.5 ± 2.1 months), the residential destination was home for 46.7% of patients. Of the patients, 48% were treated with EVAR and 49.6% with OSR (p = .48). More patients aged < 80 years (55.9%) where living at home (p < .001) at follow up. The mean QoL subscore for environment was 16.4 ± 2.1, physical health 14.5 ± 3.0, psychological health 15.5 ± 2.3, and social relationships 15.0 ± 2.6. Analyses of treatment modalities showed no statistically significant differences. Patients aged < 80 years had a higher mean physical health subscore (14.8 ± 2.8; p = .015). The median health score on the EQ-5D-5L was 72.3 ± 19.2. No difference was found between treatments. Daily activities favoured the younger cohort (p = .019).

Conclusion: There was no difference regarding QoL and last residential destination in both treatment arms over the long term. Both EVAR and OSR are justified in treating rAAA. Age alone should not be a decisive argument, but elderly patients have a lower likelihood of return to their home situation. Patients should be informed that if they survive the peri-operative period, the chances are that they will experience life comparable with the general elderly population living at home.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

紧急腹主动脉瘤修补术后的长期生活质量、健康状况和居住地。

研究目的这项回顾性、多中心、观察性队列研究旨在评估用血管内动脉瘤修补术（EVAR）或开放手术修补术（OSR）成功治疗腹主动脉瘤破裂（rAAA）后的长期生活质量、健康状况和居住地：纳入5家大型教学医院2013年1月1日至2018年12月31日经计算机断层扫描证实为rAAA的连续患者。登记随访期间的死亡率、发病率、出院去向和居住去向。生活质量（QoL）通过世界卫生组织生活质量BREF问卷进行测量，健康状况通过欧洲生活质量五级问卷（EQ-5D-5L）进行测量。对 OSR 和 EVAR 以及年龄进行了分组分析：共有 349 名患者入组：168人（48.1%）接受了EVAR治疗。30天、1年和5年的总生存率分别为74.2%、66.0%和45.0%。在随访期间（59.5 ± 2.1个月），46.7%的患者居住在家中。其中，48%的患者接受了EVAR治疗，49.6%的患者接受了OSR治疗（P = .48）。年龄较大的患者较多从长期来看，两种治疗方法的患者在生活质量和最后居住地方面没有差异。EVAR和OSR治疗rAAA都是合理的。年龄本身不应成为决定性因素，但老年患者重返家园的可能性较低。应告知患者，如果他们能熬过围手术期，他们将有机会体验到与一般居家老人相当的生活。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

European Journal of Vascular and Endovascular Surgery 医学-外科

CiteScore

6.80

自引率

15.80%

发文量

471

审稿时长

66 days

期刊介绍： The European Journal of Vascular and Endovascular Surgery is aimed primarily at vascular surgeons dealing with patients with arterial, venous and lymphatic diseases. Contributions are included on the diagnosis, investigation and management of these vascular disorders. Papers that consider the technical aspects of vascular surgery are encouraged, and the journal includes invited state-of-the-art articles. Reflecting the increasing importance of endovascular techniques in the management of vascular diseases and the value of closer collaboration between the vascular surgeon and the vascular radiologist, the journal has now extended its scope to encompass the growing number of contributions from this exciting field. Articles describing endovascular method and their critical evaluation are included, as well as reports on the emerging technology associated with this field.