Abstract：
OBJECTIVE: This study aimed to describe surgical trends, survival, and infection related complications (IRC) in a Danish cohort of patients with infective native aortic aneurysms (INAAs).
METHODS: A retrospective nationwide cohort study including all patients in Denmark who were surgically treated for abdominal INAA between 2000 and 2020 was conducted. Patients were identified through the Danish vascular registry, Karbase, which is a database registering all patients treated with vascular surgery in Denmark. Subsequent data on clinical presentation, treatment, all cause mortality, and complications were obtained from the electronic patient charts.
RESULTS: Seventy-five patients were included in the study, of whom 60 (80%) were male, with a median age of 69 (IQR 64, 75) years. Open surgical repair (OSR) was performed in 54 (72%) patients and endovascular aortic repair (EVAR) in 21 (28%). Median follow up was 52 (IQR 32, 103) months. Open repair was consistently the most frequent treatment modality throughout the study period, but EVAR became more frequent over time. The 30 day survival of the total cohort was 97% (94 - 100%). Kaplan-Meier survival estimates for the cohort were 92% (95% CI 85 - 98%), 80% (95% CI 71 - 91%), 63% (95% CI 52 - 78%), and 48% (95% CI 35 - 66%) at one, three, five and 10 years, respectively. Patients treated by EVAR had comparable long term survival to patients treated by OSR, with a hazard ratio of 0.35 (95% CI 0.10 - 1.22), but was associated with better short term survival up to five years. The most common cause of death was sepsis. Five (9%) OSR patients had IRC compared with one (5%) EVAR patient.
CONCLUSIONS: In this nationwide study of patients treated for abdominal INAA, an increasing number of patients were surgically treated during the study period. Patients treated by EVAR demonstrated long term survival comparable to OSR. The incidence of post-operative IRC was low. These results should be interpreted with caution and prospective registries are needed.
METHODS: A retrospective nationwide cohort study including all patients in Denmark who were surgically treated for abdominal INAA between 2000 and 2020 was conducted. Patients were identified through the Danish vascular registry, Karbase, which is a database registering all patients treated with vascular surgery in Denmark. Subsequent data on clinical presentation, treatment, all cause mortality, and complications were obtained from the electronic patient charts.
RESULTS: Seventy-five patients were included in the study, of whom 60 (80%) were male, with a median age of 69 (IQR 64, 75) years. Open surgical repair (OSR) was performed in 54 (72%) patients and endovascular aortic repair (EVAR) in 21 (28%). Median follow up was 52 (IQR 32, 103) months. Open repair was consistently the most frequent treatment modality throughout the study period, but EVAR became more frequent over time. The 30 day survival of the total cohort was 97% (94 - 100%). Kaplan-Meier survival estimates for the cohort were 92% (95% CI 85 - 98%), 80% (95% CI 71 - 91%), 63% (95% CI 52 - 78%), and 48% (95% CI 35 - 66%) at one, three, five and 10 years, respectively. Patients treated by EVAR had comparable long term survival to patients treated by OSR, with a hazard ratio of 0.35 (95% CI 0.10 - 1.22), but was associated with better short term survival up to five years. The most common cause of death was sepsis. Five (9%) OSR patients had IRC compared with one (5%) EVAR patient.
CONCLUSIONS: In this nationwide study of patients treated for abdominal INAA, an increasing number of patients were surgically treated during the study period. Patients treated by EVAR demonstrated long term survival comparable to OSR. The incidence of post-operative IRC was low. These results should be interpreted with caution and prospective registries are needed.
摘要：
目的：本研究旨在描述手术趋势，生存,与感染相关的并发症（IRC）在一个丹麦队列感染的本地主动脉瘤（INAAs）。
方法：进行了一项全国性的回顾性队列研究，包括丹麦所有接受腹部INAA2000-2020手术治疗的患者。通过丹麦血管登记处确定患者，Karbase,这是一个数据库，记录了丹麦所有接受血管手术治疗的患者。关于临床表现的后续数据，治疗,全因死亡率,和并发症是从电子病人图表中获得的。
结果：75名患者被纳入研究，其中60人（80%）是男性，年龄中位数为69岁（IQR64,75）。54例（72％）患者进行了开放手术修复（OSR），21例（28％）患者进行了腔内主动脉修复（EVAR）。中位随访时间为52(IQR32,103)个月。在整个研究期间，开放修复始终是最常见的治疗方式。但随着时间的推移，EVAR变得更加频繁。总队列的30天生存率为97%(94-100%)。该队列的Kaplan-Meier生存率估计值为92％（95％CI85-98％），80%（95%CI71-91%），63%（95%CI52-78%），在1、3、5和10年时为48%(95%CI35-66%)，分别。接受EVAR治疗的患者与接受OSR治疗的患者具有相当的长期生存率，风险比为0.35(95%CI0.10-1.22)，但与较好的短期生存长达5年相关。最常见的死亡原因是败血症。5例（9%）OSR患者有IRC，1例（5%）EVAR患者有IRC。
结论：在这项针对接受腹部INAA治疗的患者的全国性研究中，越来越多的患者在研究期间接受手术治疗.用EVAR治疗的患者表现出与OSR相当的长期生存率。术后IRC的发生率较低。应谨慎解释这些结果，并需要预期的记录。
方法：进行了一项全国性的回顾性队列研究，包括丹麦所有接受腹部INAA2000-2020手术治疗的患者。通过丹麦血管登记处确定患者，Karbase,这是一个数据库，记录了丹麦所有接受血管手术治疗的患者。关于临床表现的后续数据，治疗,全因死亡率,和并发症是从电子病人图表中获得的。
结果：75名患者被纳入研究，其中60人（80%）是男性，年龄中位数为69岁（IQR64,75）。54例（72％）患者进行了开放手术修复（OSR），21例（28％）患者进行了腔内主动脉修复（EVAR）。中位随访时间为52(IQR32,103)个月。在整个研究期间，开放修复始终是最常见的治疗方式。但随着时间的推移，EVAR变得更加频繁。总队列的30天生存率为97%(94-100%)。该队列的Kaplan-Meier生存率估计值为92％（95％CI85-98％），80%（95%CI71-91%），63%（95%CI52-78%），在1、3、5和10年时为48%(95%CI35-66%)，分别。接受EVAR治疗的患者与接受OSR治疗的患者具有相当的长期生存率，风险比为0.35(95%CI0.10-1.22)，但与较好的短期生存长达5年相关。最常见的死亡原因是败血症。5例（9%）OSR患者有IRC，1例（5%）EVAR患者有IRC。
结论：在这项针对接受腹部INAA治疗的患者的全国性研究中，越来越多的患者在研究期间接受手术治疗.用EVAR治疗的患者表现出与OSR相当的长期生存率。术后IRC的发生率较低。应谨慎解释这些结果，并需要预期的记录。
