Whittaker JD, et al. - Researchers here studied the survival of patients who had been turned down for repair of an abdominal aortic aneurysm (AAA) and determined the factors influencing this. They recognized a significant short-term risk of mortality among patients turned down for AAA repair. Patients turned down for repair carried marked levels of comorbid disease but none of the considered factors were found to be independently predictive of the length of survival.

Methods

• From January 2013 to December 2015, researchers performed a retrospective observational study of a prospectively maintained database of all patients turned down for AAA intervention by the Black Country Vascular Network multidisciplinary team (MDT).
• Researchers recorded data on AAA size, cardiopulmonary exercise testing (CPET) and cause of death.

Results

• Researchers recognized 112 patients; median age at turndown was 83.9 years (IQR 10.2 years).
• At turndown, the median AAA size was 63 mm (IQR 16.7 mm).
• The median follow-up of 324 days (IQR 537.5 days) was performed after turndown.
• After 2 years, 64 patients (57.1%) died; median survival time was 462 days (IQR 579 days).
• A significantly larger AAA dimension (median 65 mm, IQR 18.5 mm) was evident among patients who died compared to those surviving to date (median 59 mm, IQR 10 mm, P = .004).
• Cox regression analysis suggested that the probability of 1 year survival in the whole population was 0.614.
• The 2 year survival probability of 0.388 was observed.
• They recognized no factors having significant influence over survival, when accounting for age, gender, AAA dimension, and British Aneurysm Repair risk score.
• Thirty had an accessible cause of death among the 64 deceased patients: 36.7% of these were due to ruptured AAAs.
• They noticed no significant difference in AAA size between those dying of ruptures and those dying of other causes (P = .225, mean 74 mm and 67 mm respectively).