The Impact of Frailty on Outcomes of Proximal Aortic Aneurysm Surgery : A Nationwide Analysis
(1) Background: This study examines frailty's impact on proximal aortic surgery outcomes. (2) Methods: All patients with a thoracic aortic aneurysm who underwent aortic root, ascending aorta, or arch surgery from the 2016-2017 National Inpatient Sample were included. Frailty was defined by the Adjusted Clinical Groups Frailty Indicator. Outcomes of interest included in-hospital mortality and a composite of death, stroke, acute kidney injury (AKI), and major bleeding (MACE). (3) Results: Among 5745 patients, 405 (7.0%) met frailty criteria. Frail patients were older, with higher rates of chronic pulmonary disease, diabetes, and chronic kidney disease. There was no difference in in-hospital death (4.9% vs. 2.4%, p = 0.169); however, the frail group exhibited higher rates of stroke and AKI. Frail patients had a longer length of stay (17 vs. 8 days), and higher rates of non-home discharge (74.1% vs. 54.3%) than non-frail patients (both p < 0.001). Sensitivity analysis confirmed increased morbidity and mortality in frail individuals. After adjusting for patient comorbidities and hospital characteristics, frailty independently predicted MACE (OR 4.29 [1.88-9.78], p = 0.001), while age alone did not (OR 1.00 [0.99-1.02], p = 0.568). Urban teaching center status predicted a lower risk of MACE (OR 0.27 [0.08-0.94], p = 0.039). (4) Conclusions: Frailty is associated with increased morbidity in proximal aortic surgery and is a more significant predictor of mortality than age. Coordinated treatment in urban institutions may enhance outcomes for this high-risk group.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
|---|---|
| Enthalten in: |
Journal of cardiovascular development and disease - 11(2024), 1 vom: 20. Jan. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Percy, Edward D [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 28.01.2024 published: Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.3390/jcdd11010032 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367670747 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367670747 | ||
| 003 | DE-627 | ||
| 005 | 20240128232146.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240126s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3390/jcdd11010032 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1273.xml |
| 035 | |a (DE-627)NLM367670747 | ||
| 035 | |a (NLM)38276658 | ||
| 035 | |a (PII)32 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Percy, Edward D |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Impact of Frailty on Outcomes of Proximal Aortic Aneurysm Surgery |b A Nationwide Analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 28.01.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a (1) Background: This study examines frailty's impact on proximal aortic surgery outcomes. (2) Methods: All patients with a thoracic aortic aneurysm who underwent aortic root, ascending aorta, or arch surgery from the 2016-2017 National Inpatient Sample were included. Frailty was defined by the Adjusted Clinical Groups Frailty Indicator. Outcomes of interest included in-hospital mortality and a composite of death, stroke, acute kidney injury (AKI), and major bleeding (MACE). (3) Results: Among 5745 patients, 405 (7.0%) met frailty criteria. Frail patients were older, with higher rates of chronic pulmonary disease, diabetes, and chronic kidney disease. There was no difference in in-hospital death (4.9% vs. 2.4%, p = 0.169); however, the frail group exhibited higher rates of stroke and AKI. Frail patients had a longer length of stay (17 vs. 8 days), and higher rates of non-home discharge (74.1% vs. 54.3%) than non-frail patients (both p < 0.001). Sensitivity analysis confirmed increased morbidity and mortality in frail individuals. After adjusting for patient comorbidities and hospital characteristics, frailty independently predicted MACE (OR 4.29 [1.88-9.78], p = 0.001), while age alone did not (OR 1.00 [0.99-1.02], p = 0.568). Urban teaching center status predicted a lower risk of MACE (OR 0.27 [0.08-0.94], p = 0.039). (4) Conclusions: Frailty is associated with increased morbidity in proximal aortic surgery and is a more significant predictor of mortality than age. Coordinated treatment in urban institutions may enhance outcomes for this high-risk group | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aortic aneurysm | |
| 650 | 4 | |a aortic surgery | |
| 650 | 4 | |a frailty | |
| 700 | 1 | |a Faggion Vinholo, Thais |e verfasserin |4 aut | |
| 700 | 1 | |a Newell, Paige |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Supreet |e verfasserin |4 aut | |
| 700 | 1 | |a Hirji, Sameer |e verfasserin |4 aut | |
| 700 | 1 | |a Awtry, Jake |e verfasserin |4 aut | |
| 700 | 1 | |a Semco, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Chowdhury, Muntasir |e verfasserin |4 aut | |
| 700 | 1 | |a Reed, Alexander K |e verfasserin |4 aut | |
| 700 | 1 | |a Asokan, Sainath |e verfasserin |4 aut | |
| 700 | 1 | |a Malarczyk, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Okoh, Alexis |e verfasserin |4 aut | |
| 700 | 1 | |a Harloff, Morgan |e verfasserin |4 aut | |
| 700 | 1 | |a Yazdchi, Farhang |e verfasserin |4 aut | |
| 700 | 1 | |a Kaneko, Tsuyoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Sabe, Ashraf A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of cardiovascular development and disease |d 2014 |g 11(2024), 1 vom: 20. Jan. |w (DE-627)NLM248446517 |x 2308-3425 |7 nnns |
| 773 | 1 | 8 | |g volume:11 |g year:2024 |g number:1 |g day:20 |g month:01 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3390/jcdd11010032 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 11 |j 2024 |e 1 |b 20 |c 01 | ||