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Survival after surgery of the ascending aorta: a matched cohort study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.ORCID iD: 0000-0002-3002-4877
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.ORCID iD: 0000-0002-9279-2791
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2022 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 62, no 3Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Surgery of ascending aortic aneurysms is performed prophylactically or acute. The expected survival after surgery is uncertain. The goal of this study was to compare mortality in people with aortic surgery with matched controls.

METHODS: All patients undergoing ascending aortic surgery at Umeå University Hospital from 1988 to 2012, who previously participated in 1 of 3 population-based health surveys, were matched to 2 randomly selected controls from the same health survey and followed until death or until censoring on 24 August 2017, whichever came first. Mortality was calculated using the Kaplan-Meier method and the log-rank test. Cox regression analyses were made for all-cause mortality, adjusted for traditional cardiovascular risk factors. Deaths during the first 90 days after surgery and at >90 days postoperatively were studied separately.

RESULTS: The median follow-up time was 9.2 years. A total of 61 of 189 patients and 51 of 370 controls died [hazard ratio (HR) 2.77, 95% confidence interval (CI) 1.91-4.01]. Mortality was increased during the first 90 days post-surgery (HR 43.4, 95% CI 5.83-323), as well as after the first 90 days (HR 1.90, 95% CI 1.25-2.88) and after acute surgery (HR 6.05, 95% CI 2.92-12.56) as well as after elective surgery (HR 2.10, 95% CI 1.35-3.27). Among 57 surgical patients with information about cause of death, 23 (40%) died of aortic disease.

CONCLUSIONS: During follow-up, more patients died than matched controls. Findings were consistent when adjusting for traditional cardiovascular risk factors and across subgroups. Both short-term and long-term postoperative deaths were increased as well.

Place, publisher, year, edition, pages
Oxford University Press, 2022. Vol. 62, no 3
Keywords [en]
aortic aneurysm, aortic dissection, surgery, survival, Thoracic aorta
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-200112DOI: 10.1093/ejcts/ezac161ISI: 000784733900001PubMedID: 35394018Scopus ID: 2-s2.0-85138458169OAI: oai:DiVA.org:umu-200112DiVA, id: diva2:1702911
Funder
Region VästerbottenSwedish Heart Lung FoundationKonung Gustaf V:s och Drottning Victorias FrimurarestiftelseAvailable from: 2022-10-12 Created: 2022-10-12 Last updated: 2023-05-22Bibliographically approved

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Skoglund Larsson, LinnLjungberg, JohanJohansson, LarsCarlberg, BoSöderberg, StefanBrunström, Mattias

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