PMID- 21908210
OWN - NLM
STAT- MEDLINE
DCOM- 20120110
LR  - 20111123
IS  - 1532-2165 (Electronic)
IS  - 1078-5884 (Linking)
VI  - 42
IP  - 6
DP  - 2011 Dec
TI  - A meta-analysis and metaregression analysis of factors influencing mortality 
      after endovascular repair of ruptured abdominal aortic aneurysms.
PG  - 775-86
LID - 10.1016/j.ejvs.2011.07.028 [doi]
AB  - OBJECTIVE: To determine factors that may influence the perioperative mortality 
      after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs) using 
      metaregression analysis. METHODS: A meta-analysis of all English-language 
      literature with information on mortality rates after endovascular repair of RAAAs 
      was conducted. A metaregression was subsequently performed to determine the 
      impact on mortality of the following 8 factors: patient age; mid-time study 
      point; anaesthesia; endograft configuration; haemodynamic instability; use of 
      aortic balloon; conversion to open repair; and abdominal compartment syndrome. 
      RESULTS: The pooled perioperative mortality across the 46 studies (1397 patients) 
      was 24.3% (95% CI: 20.7-28.3%). Of the 8 variables, only bifurcated approach was 
      significantly associated with reduced mortality (p = 0.005). A moderate negative 
      correlation was observed between bifurcated approach and haemodynamic instability 
      (-0.35). There was still a strong association between bifurcated approach and 
      mortality after simultaneously adjusting for haemodynamic instability, indicating 
      that the latter was not a major factor in explaining the observed association. 
      CONCLUSIONS: Endovascular repair of RAAAs is associated with acceptable mortality 
      rates. Patients having a bifurcated endograft were less likely to die. This may 
      be due to some surgeons opting for a bifurcated approach in patients with better 
      haemodynamic condition. Further studies will be needed to clarify this.
CI  - Copyright (c) 2011 European Society for Vascular Surgery. Published by Elsevier 
      Ltd. All rights reserved.
FAU - Karkos, C D
AU  - Karkos CD
AD  - The 5th Department of Surgery, Medical School, Aristotle University of 
      Thessaloniki, Hippocratio Hospital, Greece. ckarkos@hotmail.com
FAU - Sutton, A J
AU  - Sutton AJ
FAU - Bown, M J
AU  - Bown MJ
FAU - Sayers, R D
AU  - Sayers RD
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20110909
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty/*mortality
MH  - Aortic Aneurysm, Abdominal/*mortality/*therapy
MH  - Aortic Rupture/*mortality/*therapy
MH  - Blood Vessel Prosthesis Implantation
MH  - Cause of Death
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Intra-Abdominal Hypertension/mortality
MH  - Male
MH  - Prognosis
MH  - Regression Analysis
MH  - Risk Factors
EDAT- 2011/09/13 06:00
MHDA- 2012/01/11 06:00
CRDT- 2011/09/13 06:00
PHST- 2011/03/09 00:00 [received]
PHST- 2011/07/19 00:00 [accepted]
PHST- 2011/09/13 06:00 [entrez]
PHST- 2011/09/13 06:00 [pubmed]
PHST- 2012/01/11 06:00 [medline]
AID - S1078-5884(11)00533-8 [pii]
AID - 10.1016/j.ejvs.2011.07.028 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 2011 Dec;42(6):775-86. doi: 10.1016/j.ejvs.2011.07.028. 
      Epub 2011 Sep 9.