Sex-specific differences in alive hospital discharge following infrarenal abdominal aortic aneurysm repair.
Eur Heart J
; 2024 Sep 24.
Article
in En
| MEDLINE
| ID: mdl-39315612
ABSTRACT
BACKGROUND AND AIMS:
A longer time to alive hospital discharge following infrarenal abdominal aortic aneurysm (AAA) repair is associated with reduced patient-satisfaction and increased length of stay, hospital-acquired deconditioning, infection and costs. This study investigated sex-specific differences in, and drivers of, the rate of alive hospital discharge.METHODS:
Examination of UK National Vascular Registry (UK NVR), 2014-2019 and Swedish National Patient Registry (SE NPR) elective AAA patients, 2010-2018, for endovascular (EVAR) or open (OAR) aneurysm repair. Cox models assessed sex-specific difference in rate of alive hospital discharge, adjusting for co-morbidity, anatomy, standard-of-care, post-operative complications, and year, with in-hospital death as the competing risk.RESULTS:
29,751 AAA repairs (UK NVR -EVAR 125181532; OAR 6803837; SE NPR - EVAR 4234792; OAR 2638497, menwomen) were assessed. For EVAR, the unadjusted rate of alive hospital discharge was â¼25% lower for women (UK NVR HR 0.75 [0.71-0.80], p<.001; SE NPR HR 0.75 [0.69-0.81], p<.001). Following adjustment the sex-specific hazard ratio narrowed but remained significant (UK NVR HR 0.83 [0.79-0.88], p<.001; SE NPR HR 0.83 [0.76-0.89], p<.001). For OAR, the rate of alive hospital discharge was 23-27% lower for women (UK NVR HR 0.73 [0.67-0.78], p<.001; SE NPR HR 0.77 [0.70-0.85], p<.001). Following adjustment the sex-specific hazard ratio narrowed (UK NVR HR 0.82 [0.76-0.88], p<.001; SE NPR HR 0.79 [0.72-0.88], p<.001) but remained significant.CONCLUSIONS:
Women have a 25% lower rate of alive discharge after aortic surgery, despite adjustment for pre/peri- and postoperative parameters. Efforts to increase rate of alive hospital discharge for women should be sought.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Eur Heart J
Year:
2024
Document type:
Article
Affiliation country:
United kingdom
Country of publication:
United kingdom