Preoperative spirometry results as a determinant for long-term mortality after EVAR for AAA

Area of Science:

• Cardiovascular Surgery
• Pulmonary Medicine
• Medical Statistics

Background:

• Endovascular aneurysm repair (EVAR) is a standard treatment for infrarenal abdominal aortic aneurysm (AAA).
• Long-term outcomes after EVAR are influenced by various patient factors.
• The role of pulmonary function in predicting mortality post-EVAR requires further investigation.

Purpose of the Study:

• To analyze lung function test determinants for long-term mortality following EVAR for infrarenal AAA.
• To identify specific spirometric parameters associated with increased mortality risk.

Main Methods:

• Retrospective analysis of 304 patients undergoing elective EVAR between May 1998 and February 2006.
• Severity of obstructive lung disease graded using Global Initiative for Chronic Obstructive Lung Diseases (GOLD) guidelines.
• Mortality data collected until December 2010 with a median follow-up of 68 months.

Main Results:

• Lower forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were independently associated with long-term mortality (p=0.002 and p=0.003, respectively).
• Other independent predictors of mortality included severe chronic obstructive pulmonary disease (COPD) (grade ≥3), anemia, advanced chronic kidney disease (stage ≥3), and age ≥80 years.
• Patients with COPD grade ≥3 or low PaO2 had a significantly higher hazard ratio for mortality (HR 2.06).

Conclusions:

• Lung function parameters, specifically FEV1 and FVC, are significant independent predictors of long-term mortality after EVAR for AAA.
• Formal pre-operative evaluation of lung function using spirometry is essential for comprehensive risk assessment in patients undergoing AAA repair.
• These findings underscore the importance of pulmonary assessment in optimizing patient selection and management for EVAR.