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Sex-specific differences in alive hospital discharge following infrarenal abdominal aortic aneurysm repair.

Authors :
Pouncey AL
Sweeting MJ
Bicknell C
Powell JT
Lübcke J
Gunnarsson K
Wanhainen A
Mani K
Source :
European heart journal [Eur Heart J] 2024 Sep 24. Date of Electronic Publication: 2024 Sep 24.
Publication Year :
2024
Publisher :
Ahead of Print

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.<br />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.<br />Results: 29,751 AAA repairs (UK NVR -EVAR 12518:1532; OAR 6803:837; SE NPR - EVAR 4234:792; OAR 2638:497, men:women) were assessed. For EVAR, the unadjusted rate of alive hospital discharge was ∼25% 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.<br />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.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Details

Language :
English
ISSN :
1522-9645
Database :
MEDLINE
Journal :
European heart journal
Publication Type :
Academic Journal
Accession number :
39315612
Full Text :
https://doi.org/10.1093/eurheartj/ehae675