Evidence map›Paper›PMID 38013041›Full record

ArticleJournal of vascular surgery2024

The association of ruptured abdominal aortic aneurysm diameter with mortality in the International Consortium of Vascular Registries.

Sinead Gormley, Jialin Mao, Art Sedrakyan, Adam W Beck, Kevin Mani, Barry Beiles, Zoltan Szeberin, Maarit Venermo, Kevin Cassar, Manar Khashram and 1 more

Open access · greenAbstract read
In one paragraph

Article in Journal of vascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 7 countries.

Sinead GormleyDepartment of Surgery, University of Auckland, Auckland, NZ; Department of Vascular & Endovascular Surgery, Waikato Hospital, Hamilton, NZ.
Jialin MaoDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY.
Art SedrakyanDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY.
Adam W BeckDivision of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL.
Kevin ManiDepartment of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Barry BeilesAustralasian Vascular Audit, Australia & New Zealand Society for Vascular Surgery, Melbourne, Australia.
Zoltan SzeberinDepartment of Vascular Surgery, Semmelweis University, Budapest, Hungary.
Maarit VenermoDepartment of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Kevin CassarDepartment of Surgery, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
Manar KhashramDepartment of Surgery, University of Auckland, Auckland, NZ; Department of Vascular & Endovascular Surgery, Waikato Hospital, Hamilton, NZ. Electronic address: manar.khashram@gmail.com.
International Consortium of Vascular Registries (ICVR)
Cornell University · USWaikato Hospital · NZAustralasian Society for Infectious Diseases · AUSemmelweis University · HUUniversity of Alabama at Birmingham · USUniversity of Helsinki · FIUniversity of Malta · MTUppsala University · SE

Funding

Leveraging linked registry and electronic health records to examine long-term patient outcomes after peripheral vascular intervention"K01HL159315 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI MAO, JIALIN · 2021 to 2025
$810k
NHLBI NIH HHS K01 HL159315
6 · The paper itself

Abstract

backgroundThe mortality after ruptured abdominal aortic aneurysm (rAAA) repair is high, despite improvements in perioperative care, centralization of emergency vascular surgical services, and the introduction of endovascular aneurysm repair (EVAR). The diameter of intact AAA has been shown to be a predictor of short- and long-term survival. The aim of this study was to analyze the impact of AAA diameter on mortality for rAAA repair using contemporary data collected from the International Consortium of Vascular Registries and compare outcomes by sex and the type of repair patients received.

methodsProspective registry data on repair of rAAA from seven countries were collected from 2010 to 2016. The primary outcome was perioperative mortality after EVAR and open surgical repair (OSR). Data were stratified by type of repair and sex. Logistic regression models were used to estimate odds ratio (OR) for the association between AAA diameter and perioperative mortality and the association between type of repair and mortality. Multivariable logistic regression models were used to adjust for differences in patient characteristics.

resultsThe study population consisted of 6428 patients with a mean age ranging from 70.2 to 75.4 years; the mean AAA diameter was 7.7 ± 1.8 cm. Females had a significantly smaller AAA diameter at presentation compared with males (6.9 ± 1.6 cm vs 7.9 ± 1.8 cm; P < .001). who underwent OSR had larger AAA diameters compared with those who underwent EVAR (P < .001). Females who underwent repair were significantly older (P < .001). Males were more likely to have cardiac disease, diabetes mellitus, and renal impairment. Overall, AAA diameter was a predictor of mortality in univariate and multivariate analysis. When analyzing EVAR and OSR separately, the impact of AAA diameter per cm increase on mortality was apparent in both males and females undergoing EVAR, but not OSR (EVAR: male OR, 1.09 [95% confidence interval, 1.03-1.16] and EVAR: female OR, 1.17 [95% confidence interval, 1.02-1.35]). The early mortality rate for males and females who underwent EVAR was 18.9% and 25.9% (P < .001), respectively. The corresponding mortality for males and females who underwent OSR was 30.2% and 38.6% (P < .001), respectively.

conclusionsIn these real-world international data, there is a significant association between rAAA diameters and early mortality in males and females. This association was more evident in patients undergoing EVAR, but not shown in OSR. Despite improvements in overall AAA repair outcomes, the risk of mortality after rAAA repair is consistently higher for females.

Indexed as

Aortic Aneurysm, AbdominalAortic RuptureBlood Vessel Prosthesis ImplantationEndovascular ProceduresAgedFemaleHumansMalePostoperative ComplicationsRegistriesRetrospective StudiesRisk FactorsTreatment OutcomeAbdominal aortic aneurysmEVARMortalityRegistrySurgery

Identifiers

PMID38013041
PMCPMC11144387
OpenAlexW4388997127

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.