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Functional Performance After Complex Endovascular Aortic Repair: A Single-Center Retrospective Cohort Study
Britt W C M Warmerdam1, Yara van Holstein2, Daniël Eefting1
1Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Summary
Complex endovascular aortic repair (EVAR) shows promising functional outcomes, with no patients discharged to nursing homes. Further research is needed to identify patients at risk for functional decline after EVAR.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Patient Outcomes
Background:
- Complex endovascular aortic repair (EVAR) is an option for complex aortic aneurysms.
- Short-term technical and survival outcomes are established.
- Long-term functional outcomes in this older, frail patient group remain unclear.
Purpose of the Study:
- To describe postoperative functional outcomes in patients undergoing complex EVAR.
- To assess functional decline and mortality in this patient cohort.
Main Methods:
- Retrospective cohort study of 82 patients undergoing complex EVAR (July 2013-September 2020).
- Geriatric care pathway implemented for functional assessment ((Instrumental) Activities of Daily Living - (I)ADL scores).
- Outcomes included nursing home discharge, 12-month mortality, and functional decline at 12 months.
Main Results:
- Mean age was 73.3 years; 82.9% were male.
- 12-month mortality was 14.6%. No patients were discharged to a nursing home.
- Among 23 patients in geriatric follow-up, 21.7% showed functional decline and 17.4% died by 12 months.
Conclusions:
- Complex EVAR demonstrates promising functional performance at 12 months, with no new nursing home admissions.
- Further research should identify patients at risk for functional decline post-EVAR.
- Multidisciplinary efforts are needed to prevent postoperative functional deterioration.
