Tijmen F C M Nederstigt, Daphne van der Veen, Jan-Willem Lardenoije, Michel Reijnen
{"title":"紧急腹主动脉瘤修补术后的长期生活质量、健康状况和居住地。","authors":"Tijmen F C M Nederstigt, Daphne van der Veen, Jan-Willem Lardenoije, Michel Reijnen","doi":"10.1016/j.ejvs.2024.11.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This retrospective, multicentre, observational cohort study aimed to assess the long term quality of life, health status, and residential destination after successful treatment of a ruptured abdominal aortic aneurysm (rAAA) treated with endovascular aneurysm repair (EVAR) or open surgical repair (OSR).</p><p><strong>Methods: </strong>Consecutive patients from five large teaching hospitals with a computed tomography confirmed rAAA from 1 January 2013 to 31 December 2018 were included. Mortality, morbidity, discharge destination, and residential destination through follow up were registered. Quality of life (QoL) was measured with the World Health Organization Quality of Life BREF questionnaire, and health status with the 5 Level EuroQoL 5 Dimension (EQ-5D-5L) questionnaire. Subgroup analyses were performed between OSR and EVAR, and age < 80 years and ≥ 80 years (octogenarians).</p><p><strong>Results: </strong>A total of 349 patients were enrolled: 168 (48.1%) were treated with EVAR. The overall 30 day, one year, and five year survival rates were 74.2% 66.0%, and 45.0%, respectively. At follow up (59.5 ± 2.1 months), the residential destination was home for 46.7% of patients. Of the patients, 48% were treated with EVAR and 49.6% with OSR (p = .48). More patients aged < 80 years (55.9%) where living at home (p < .001) at follow up. The mean QoL subscore for environment was 16.4 ± 2.1, physical health 14.5 ± 3.0, psychological health 15.5 ± 2.3, and social relationships 15.0 ± 2.6. Analyses of treatment modalities showed no statistically significant differences. Patients aged < 80 years had a higher mean physical health subscore (14.8 ± 2.8; p = .015). The median health score on the EQ-5D-5L was 72.3 ± 19.2. No difference was found between treatments. Daily activities favoured the younger cohort (p = .019).</p><p><strong>Conclusion: </strong>There was no difference regarding QoL and last residential destination in both treatment arms over the long term. Both EVAR and OSR are justified in treating rAAA. Age alone should not be a decisive argument, but elderly patients have a lower likelihood of return to their home situation. Patients should be informed that if they survive the peri-operative period, the chances are that they will experience life comparable with the general elderly population living at home.</p>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long Term Quality of Life, Health Status, and Residential Destination after Emergency Abdominal Aortic Aneurysm Repair.\",\"authors\":\"Tijmen F C M Nederstigt, Daphne van der Veen, Jan-Willem Lardenoije, Michel Reijnen\",\"doi\":\"10.1016/j.ejvs.2024.11.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This retrospective, multicentre, observational cohort study aimed to assess the long term quality of life, health status, and residential destination after successful treatment of a ruptured abdominal aortic aneurysm (rAAA) treated with endovascular aneurysm repair (EVAR) or open surgical repair (OSR).</p><p><strong>Methods: </strong>Consecutive patients from five large teaching hospitals with a computed tomography confirmed rAAA from 1 January 2013 to 31 December 2018 were included. Mortality, morbidity, discharge destination, and residential destination through follow up were registered. Quality of life (QoL) was measured with the World Health Organization Quality of Life BREF questionnaire, and health status with the 5 Level EuroQoL 5 Dimension (EQ-5D-5L) questionnaire. Subgroup analyses were performed between OSR and EVAR, and age < 80 years and ≥ 80 years (octogenarians).</p><p><strong>Results: </strong>A total of 349 patients were enrolled: 168 (48.1%) were treated with EVAR. The overall 30 day, one year, and five year survival rates were 74.2% 66.0%, and 45.0%, respectively. At follow up (59.5 ± 2.1 months), the residential destination was home for 46.7% of patients. Of the patients, 48% were treated with EVAR and 49.6% with OSR (p = .48). More patients aged < 80 years (55.9%) where living at home (p < .001) at follow up. The mean QoL subscore for environment was 16.4 ± 2.1, physical health 14.5 ± 3.0, psychological health 15.5 ± 2.3, and social relationships 15.0 ± 2.6. Analyses of treatment modalities showed no statistically significant differences. Patients aged < 80 years had a higher mean physical health subscore (14.8 ± 2.8; p = .015). The median health score on the EQ-5D-5L was 72.3 ± 19.2. No difference was found between treatments. Daily activities favoured the younger cohort (p = .019).</p><p><strong>Conclusion: </strong>There was no difference regarding QoL and last residential destination in both treatment arms over the long term. Both EVAR and OSR are justified in treating rAAA. Age alone should not be a decisive argument, but elderly patients have a lower likelihood of return to their home situation. Patients should be informed that if they survive the peri-operative period, the chances are that they will experience life comparable with the general elderly population living at home.</p>\",\"PeriodicalId\":55160,\"journal\":{\"name\":\"European Journal of Vascular and Endovascular Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Vascular and Endovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ejvs.2024.11.002\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Vascular and Endovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ejvs.2024.11.002","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Long Term Quality of Life, Health Status, and Residential Destination after Emergency Abdominal Aortic Aneurysm Repair.
Objective: This retrospective, multicentre, observational cohort study aimed to assess the long term quality of life, health status, and residential destination after successful treatment of a ruptured abdominal aortic aneurysm (rAAA) treated with endovascular aneurysm repair (EVAR) or open surgical repair (OSR).
Methods: Consecutive patients from five large teaching hospitals with a computed tomography confirmed rAAA from 1 January 2013 to 31 December 2018 were included. Mortality, morbidity, discharge destination, and residential destination through follow up were registered. Quality of life (QoL) was measured with the World Health Organization Quality of Life BREF questionnaire, and health status with the 5 Level EuroQoL 5 Dimension (EQ-5D-5L) questionnaire. Subgroup analyses were performed between OSR and EVAR, and age < 80 years and ≥ 80 years (octogenarians).
Results: A total of 349 patients were enrolled: 168 (48.1%) were treated with EVAR. The overall 30 day, one year, and five year survival rates were 74.2% 66.0%, and 45.0%, respectively. At follow up (59.5 ± 2.1 months), the residential destination was home for 46.7% of patients. Of the patients, 48% were treated with EVAR and 49.6% with OSR (p = .48). More patients aged < 80 years (55.9%) where living at home (p < .001) at follow up. The mean QoL subscore for environment was 16.4 ± 2.1, physical health 14.5 ± 3.0, psychological health 15.5 ± 2.3, and social relationships 15.0 ± 2.6. Analyses of treatment modalities showed no statistically significant differences. Patients aged < 80 years had a higher mean physical health subscore (14.8 ± 2.8; p = .015). The median health score on the EQ-5D-5L was 72.3 ± 19.2. No difference was found between treatments. Daily activities favoured the younger cohort (p = .019).
Conclusion: There was no difference regarding QoL and last residential destination in both treatment arms over the long term. Both EVAR and OSR are justified in treating rAAA. Age alone should not be a decisive argument, but elderly patients have a lower likelihood of return to their home situation. Patients should be informed that if they survive the peri-operative period, the chances are that they will experience life comparable with the general elderly population living at home.
期刊介绍：
The European Journal of Vascular and Endovascular Surgery is aimed primarily at vascular surgeons dealing with patients with arterial, venous and lymphatic diseases. Contributions are included on the diagnosis, investigation and management of these vascular disorders. Papers that consider the technical aspects of vascular surgery are encouraged, and the journal includes invited state-of-the-art articles.
Reflecting the increasing importance of endovascular techniques in the management of vascular diseases and the value of closer collaboration between the vascular surgeon and the vascular radiologist, the journal has now extended its scope to encompass the growing number of contributions from this exciting field. Articles describing endovascular method and their critical evaluation are included, as well as reports on the emerging technology associated with this field.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
