Clinical predictors of mortality and endoleak following EVAR and TEVAR

EVAR 和 TEVAR 术后死亡率和内漏的临床预测因素

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Abstract

OBJECTIVE: To evaluate clinical outcomes and identify predictors of mortality and endoleak after endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) procedures. METHODS: A retrospective cohort study of 164 EVAR and TEVAR patients (January 2000-December 2022) was conducted. Data on demographics, comorbidities, aneurysm size, and clinical outcomes were extracted. Statistical analysis included Pearson's chi-square test, Student's t-test, Mann-Whitney U test, and multivariate logistic regression. Model performance was assessed by receiver operating characteristic and Hosmer-Lemeshow tests. RESULTS: Overall mortality was 7%, and endoleak incidence was 20.75%. Diabetes mellitus was an independent predictor of mortality [adjusted odds ratio (AOR) = 3.93; 95% CI: 1.51-10.24, P = 0.005], and aneurysm size (>7 cm) independently predicted endoleaks (AOR = 3.21; 95% CI: 1.28-8.06, P = 0.013). Physician specialty and procedure type did not significantly predict outcomes. Model discrimination (area under the curve = 0.96) and calibration (Hosmer-Lemeshow P = 0.400) were strong. CONCLUSION: Diabetes mellitus and aneurysm size (>7 cm) significantly influence clinical outcomes following EVAR and TEVAR, guiding risk stratification and patient management.

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