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Cardiac medical therapy among patients undergoing abdominal aortic aneurysm repair.
- Source :
-
Annals of vascular surgery [Ann Vasc Surg] 2006 Sep; Vol. 20 (5), pp. 569-76. Date of Electronic Publication: 2006 Jun 23. - Publication Year :
- 2006
-
Abstract
- Open abdominal aortic aneurysm (AAA) repair is a common surgical procedure associated with high mortality rates. Our objective was to describe the use of in-hospital cardiac medical therapy among patients undergoing open AAA repair and to examine the effect of perioperative cardiac medical therapy on in-hospital mortality. We examined clinical data and in-hospital medication use among 223 patients who underwent open AAA repair at three North American hospitals, all of which used the Transition resource and cost accounting system. Medication use was described [angiotensin converting enzyme (ACE) inhibitors, aspirin, ss-blockers, and statins] within the cohort at five specific periods of time: presurgery, day of surgery, 1 day after surgery, postsurgery, and discharge. We then performed a matched case-control study where cases were defined as patients who died in-hospital. We compared medication use between cases and controls to assess its impact on in-hospital mortality. Most patients were elderly (mean age 72.5 +/- 9.8 years), 70.4% were male, and in-hospital mortality within the cohort was 10.8%. Medication use in all periods of administration was low. ss-Blocker use was highest among all classes on the day of surgery, with 20.6% of patients undergoing AAA repair receiving the medication. Less than 50% of patients received any of the medications at discharge. After adjusting for baseline differences, perioperative ACE inhibitor use showed a trend toward a protective effect [odds ratio (OR) = 0.09, 95% confidence interval (CI) 0.01-1.31, p = 0.08], and perioperative ss-blocker use was significantly associated with a decrease in mortality (OR = 0.07, 95% CI 0.01-0.87, p = 0.04). Cardiac medical therapy among patients undergoing AAA repair is low throughout all periods of hospitalization. ACE inhibitor and ss-blocker use may be associated with decreased in-hospital mortality.
- Subjects :
- Aged
Aortic Aneurysm, Abdominal mortality
Aortic Aneurysm, Abdominal surgery
Aspirin therapeutic use
Case-Control Studies
Cohort Studies
Drug Utilization statistics & numerical data
Female
Hospital Mortality
Hospitalization
Humans
Logistic Models
Male
North America
Odds Ratio
Perioperative Care statistics & numerical data
Research Design
Time Factors
Treatment Outcome
Vascular Surgical Procedures
Adrenergic beta-Antagonists therapeutic use
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Aortic Aneurysm, Abdominal drug therapy
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Platelet Aggregation Inhibitors therapeutic use
Practice Patterns, Physicians' statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0890-5096
- Volume :
- 20
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 16794911
- Full Text :
- https://doi.org/10.1007/s10016-006-9078-z