Laboratory Reference Patterns and Survival after Fenestrated Endovascular Aortic Repair: A Retrospective
Emanuel Greistofer1, Fadi Taher1, Afshin Assadian1
1Department of Vascular and Endovascular Surgery, Klinik Ottakring, Vienna, Austria.
Background:
The objective of this study was to evaluate the prognostic value of routine postoperative laboratory parameters including renal function, inflammatory markers, and hematologic indices in patients undergoing fenestrated endovascular aortic repair (FEVAR).
Methods:
We conducted a retrospective single center study of 210 patients undergoing FEVAR, analyzing perioperative laboratory changes using area outside reference (AOR) and maximum value metrics in Cox proportional hazards models, with landmark analyses excluding deaths within 30 and 365 days.
Results:
Leukocyte count and serum creatinine were associated with both short- and long-term survival. AOR models did not improve performance compared with maximum-value models. Higher maximum leukocyte and creatinine values remained associated with increased mortality in landmark analyses (hazard ratio [HR]: 1.04 per G/L and HR: 1.02 per mg/dL, respectively), whereas hemoglobin, C-reactive protein, and platelet count showed no association with survival. Leukocyte elevation remained predictive after exclusion of 30- and 365-day deaths, while creatinine lost significance beyond 1 year, indicating stronger mid-term prognostic relevance for perioperative renal deterioration.
Conclusion:
Most perioperative laboratory abnormalities after FEVAR appear to reflect physiological postoperative responses and are not independently prognostic. Only elevated maximum leukocyte and creatinine values showed a modest association with increased mortality, whereas more complex time-dependent modeling provided no additional prognostic value.
