Home > Riviste > International Angiology > Fascicoli precedenti > International Angiology 2012 August;31(4) > International Angiology 2012 August;31(4):368-75

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Estratti

INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899


eTOC

 

ORIGINAL ARTICLES  


International Angiology 2012 August;31(4):368-75

lingua: Inglese

Influence of preoperative medical assessment prior to elective endovascular aneurysm repair for abdominal aortic aneurysm

Ohrlander T. 1, Nessvi S. 2, Gottsäter A. 2, Dencker M. 3, Acosta S. 2

1 Department of Surgery, Eksjö County Hospital, Eksjö, Sweden;
2 Vascular Center, Malmö-Lund, Malmö, Sweden;
3 Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, Sweden


PDF  


AIM: The aim of this study was to compare preoperative patient evaluation by a vascular physician with a standardized workup protocol prior to elective endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), in terms of differences in patient medication and mortality.
METHODS: Consecutive patients with infrarenal AAA treated with standard EVAR from 1998 to 2006 (group 2) and 2007 to 2011 (group 1) were compared. Patients in group 1 (N.=201) were investigated preoperatively by a vascular physician, evaluating comorbidities and medication. Patients in group 2 (N.=304) underwent a standardized preoperative work-up including spirometry and echocardiography. Median time of follow-up was 23 months in group 1 and 71 months in group 2.
RESULTS: The proportion of patients who had on-going medication with anti-platelet and lipid lowering medication at admission was higher in group 1 compared to group 2 (62% versus 51%; P=0.013 and 68% versus 35%; P<0.001). In group 1, the proportion of newly instituted or increased dosage of anti-hypertensive, anti-platelet or lipid lowering medication at preoperative evaluation was 40%, 24% and 31%, respectively. The total cost for preoperative assessment per patient was 272 € in group 1 and 293 € in group 2 (P<0.001). There was no difference in 30-day (P=0.29) or long-term (P=0.24) mortality between the two groups.
CONCLUSION: Preoperative assessment by a vascular physician resulted in lower costs and improvement of medication against atherosclerosis, uncontrolled hypertension and perioperative ischemic cardiac events, but mortality was unaffected.

inizio pagina

Publication History

Per citare questo articolo

Corresponding author e-mail

Stefan.acosta@telia.com