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Archan, S; Roscher, CR; Fairman, RM; Fleisher, LA.
Revised Cardiac Risk Index (Lee) and Perioperative Cardiac Events as Predictors of Long-term Mortality in Patients Undergoing Endovascular Abdominal Aortic Aneurysm Repair.
J Cardiothorac Vasc Anesth. 2010; 24(1): 84-90. Doi: 10.1053/j.jvca.2009.04.003
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Leading authors Med Uni Graz: Farzi Sylvia Ingrid
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Abstract:: Objective: To determine if the Revised Cardiac Risk Index (Lee) is useful for stratification of patients by risk of both perioperative cardiac morbidity and long-term all-cause mortality in the setting of endovascular repair of abdominal aortic aneurysms. Design: This study was designed as a retrospective review. Setting: It was conducted at a single academic medical institution. Participants: The analysis included 225 patients with abdominal aortic aneurysms admitted to the authors' institution from 1999 to 2006. Interventions: All patients underwent endovascular aortic aneurysm repair. Measurements and Main Results: Data were collected from medical records, office charts, and physician quality-assurance databases. There were no in-hospital cardiac deaths. The major adverse cardiac event rate in the perioperative period was 6.2%. Long-term all-cause mortality was 23%. Univariate analysis showed that a history of coronary artery disease (CAD) (likelihood ratio [LR] = 8.7, p = 0.023), history of congestive heart failure (LR = 4, p = 0.042), and a Revised Cardiac Risk Index (RCRI) >= 3 (LA = 8.6, p = 0.004) were significant predictors for perioperative major adverse cardiac events. A history of CAD (LR = 10.7, p = 0.002), echocardiographic evidence of myocardial infarction (LR = 8.5, p = 0.006), exercise tolerance of only 1 block (LR = 8.4, p = 0.005), RCRI >= 3 (LR = 5.6, p = 0.022), and perioperative cardiac events (LR = 15.9, p < 0.0001) were significantly associated with long-term all-cause mortality. Perioperative cardiac events remained highly significant in predicting long-term mortality within the RCRI >= 3 subgroup (LR = 6.1, p = 0.019). Conclusions: The results of this study confirm that long-term mortality remains high after endovascular repair of abdominal aortic aneurysms. The Lee index may be a useful tool for stratification of high-risk patients from both a short- and long-term perspective in the setting of endoluminal graft repair. (C) 2010 Elsevier Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing): Aged -; Analysis of Variance -; Angioplasty - methods; Aortic Aneurysm, Abdominal - mortality; Female -; Follow-Up Studies -; Humans -; Male -; Predictive Value of Tests -; Retrospective Studies -; Risk Assessment -; Risk Factors -; Severity of Illness Index -; Survival Analysis -
Find related publications in this database (Keywords): endovascular repair; abdominal aortic aneurysms; long-term mortality; perioperative cardiac events; predictors