Nationwide analysis of risk factors for in‐hospital mortality in patients undergoing abdominal aortic aneurysm repair

• Published in: British journal of surgery 2018-03, Vol.105 (4), p.379-387
• Main Authors: Trenner, M., Kuehnl, A., Reutersberg, B., Salvermoser, M., Eckstein, H.‐H.
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Aneurysms; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Aortic aneurysms; Endovascular Procedures; Female; Germany - epidemiology; Hospital Mortality; Humans; Male; Middle Aged; Mortality; Retrospective Studies; Risk Factors; Sex Factors
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.10714

Background There is increasing awareness that women may have worse outcomes following repair of abdominal aortic aneurysm (AAA). The aim of this study was to analyse the association between sex, age and in‐hospital mortality after AAA using hospital episode data collected routinely at the nationwide level. Methods Data were extracted from the nationwide statutory Diagnosis Related Group statistics provided by the German Federal Statistical Office. Patients with a diagnosis of intact (non‐ruptured) AAA (ICD‐10 GM I71.4) and procedure codes (OPS; 2005–2013) for endovascular aneurysm repair (EVAR) (5‐38a.1*) or open aneurysm repair (5‐384.5, 5‐384.7), treated from 2005 to 2013, were included. A multilevel multivariable regression model was applied to adjust for medical risk (using the Elixhauser co‐morbidity score), type of procedure, type of admission, and to account for clustering of patients within centres. The primary outcome was in‐hospital mortality. Results Some 84 631 patients were identified, of whom 10 039 (11·9 per cent) were women. Women were significantly older than men at admission (median 74 (i.q.r. 69–80) versus 72 (66–77) years; P