首页|Social Deprivation and the Association With Survival Following Fenestrated Endovascular Aneurysm Repair
Social Deprivation and the Association With Survival Following Fenestrated Endovascular Aneurysm Repair
扫码查看
点击上方二维码区域，可以放大扫码查看
原文链接
NSTL
Elsevier
? 2021Background: Social deprivation is associated with poor clinical outcomes. It is known to have an impact on length of stay and post-operative mortality across a number of other surgical specialties. This study evaluates the impact of social deprivation on outcomes following fenestrated endovascular aneurysm repair (FEVAR). Methods: All elective FEVARs performed between 2010 and 2018 at a tertiary vascular center were analyzed. Deprivation (index of multiple deprivation [IMD]) data was sourced from the English indices of deprivation 2019, by postcode. Primary outcome was overall survival by Kaplan-Meier. Secondary outcomes included length of hospital stay (LOS) and complications. Cox-proportional hazard analyses were conducted. Results: Some 132 FEVAR patients were followed-up for 3.7 (SD 2.2) years. Fifty-seven patients lived in areas with high levels of deprivation (IMD 1–3), 34 in areas with moderate deprivation (IMD 4–6) and 41 in areas with the lowest level (IMD 7–10) of deprivation. Groups were comparable for Age, BMI, AAA diameter and co-morbidity. A higher proportion of patients from deprived areas had renal failure (15% [26.3%] vs. 9% [11.8%] P = 0.019) but no overall difference in procedure time was observed (200 min [155–250] vs. 180 min [145–240] P = 0.412). Kaplan-Meier analysis demonstrated significantly poorer survival for patients living in areas with high levels of deprivation (IMD 1–3) (P = 0.03). Mortality was comparable for IMD 4–6 and 7–10 groups. Patients from the most deprived areas had longer hospital stay (6 days [4–9] vs. 5 [3–7] P = 0.005) and higher all-cause complication rates (21 [36.8%] vs. 14 [18.4%] P = 0.02). Decreasing IMD was associated with worse survival (HR -0.85 [0.75–0.97] [P = 0.02]). Conclusions: Social deprivation was associated with increased mortality, length of stay and all-cause complication rates in patients undergoing FEVAR for complex abdominal aortic aneurysm (AAA). These results may help direct preoptimization measures to improve outcomes in higher risk sub-groups.
Choudhury E.、Rammell J.、Dattani N.、Williams R.、McCaslin J.、Prentis J.、Nandhra S.
展开 >
Northern Vascular Centre Freeman Hospital Newcastle-upon-Tyne Hospitals
Interventional Radiology Northern Vascular Centre Freeman Hospital Newcastle-upon-Tyne Hospitals
Department of Anaesthesia Newcastle upon Tyne Hospitals NHS Foundation Trust Freeman Hospital
NSTL
Elsevier
