Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair
Abstract The aim of this nationwide study was to analyze the impact of diabetes on post-operative mortality in patients undergoing AAA repair in France. This 10-year retrospective, multicenter study based on the French National electronic health data included patients undergoing AAA repair between 2...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-98893-x |
| _version_ | 1818996103278755840 |
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| author | Juliette Raffort Fabien Lareyre Roxane Fabre Ziad Mallat Christian Pradier Laurent Bailly |
| author_facet | Juliette Raffort Fabien Lareyre Roxane Fabre Ziad Mallat Christian Pradier Laurent Bailly |
| author_sort | Juliette Raffort |
| collection | DOAJ |
| description | Abstract The aim of this nationwide study was to analyze the impact of diabetes on post-operative mortality in patients undergoing AAA repair in France. This 10-year retrospective, multicenter study based on the French National electronic health data included patients undergoing AAA repair between 2010 and 2019. In-hospital post-operative mortality was analyzed using Kaplan–Meier curve survival and Log-Rank tests. A multivariate regression analysis was performed to calculate Hazard Ratios. Over 79,935 patients who underwent AAA repair, 61,146 patients (76.5%) had at least one hospital-readmission after the AAA repair, for a mean follow-up of 3.5 ± 2.5 years. Total in-hospital mortality over the 10-year study was 16,986 (21.3%) and 4581 deaths (5.8%) occurred during the first hospital stay for AAA repair. Age over 64 years old, the presence of AAA rupture and hospital readmission at 30-day were predictors of post-operative mortality (AdjHR = 1.59 CI 95% 1.51–1.67; AdjHR = 1.49 CI 95% 1.36–1.62 and AdjHR = 1.92, CI 95% 1.84–2.00). The prevalence of diabetes was significantly lower in ruptured AAA compared to unruptured AAA (14.8% vs 20.9%, P < 0.001 for type 2 diabetes and 2.5% vs 4.0%, P < 0.001 for type 1 diabetes). Type 1 diabetes was significantly associated with post-operative mortality (AdjHR = 1.30 CI 95% 1.20–1.40). For type 2 diabetes, the association was not statistically significant (Adj HR = 0.96, CI 95% 0.92–1.01). Older age, AAA rupture and hospital readmission were associated with deaths that occurred after discharge from the first AAA repair. Type 1 diabetes was identified as a risk factor of post-operative mortality. This study highlights the complex association between diabetes and AAA and should encourage institutions to report long-term follow-up after AAA repair to better understand its impact. |
| first_indexed | 2024-12-20T21:24:25Z |
| format | Article |
| id | doaj.art-dea74739716f48bfa5baaf832ccb9c10 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-20T21:24:25Z |
| publishDate | 2021-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-dea74739716f48bfa5baaf832ccb9c102022-12-21T19:26:11ZengNature PortfolioScientific Reports2045-23222021-09-011111710.1038/s41598-021-98893-xNationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repairJuliette Raffort0Fabien Lareyre1Roxane Fabre2Ziad Mallat3Christian Pradier4Laurent Bailly5Université Côte d’Azur, CHU, Inserm U1065, C3MDepartment of Vascular Surgery, Hospital of Antibes Juan-Les-PinsCoBTeK Lab, Université Côte d’AzurDivision of Cardiovascular Medicine, University of CambridgePublic Health Department, University Hospital of Nice, Université Côte d’AzurPublic Health Department, University Hospital of Nice, Université Côte d’AzurAbstract The aim of this nationwide study was to analyze the impact of diabetes on post-operative mortality in patients undergoing AAA repair in France. This 10-year retrospective, multicenter study based on the French National electronic health data included patients undergoing AAA repair between 2010 and 2019. In-hospital post-operative mortality was analyzed using Kaplan–Meier curve survival and Log-Rank tests. A multivariate regression analysis was performed to calculate Hazard Ratios. Over 79,935 patients who underwent AAA repair, 61,146 patients (76.5%) had at least one hospital-readmission after the AAA repair, for a mean follow-up of 3.5 ± 2.5 years. Total in-hospital mortality over the 10-year study was 16,986 (21.3%) and 4581 deaths (5.8%) occurred during the first hospital stay for AAA repair. Age over 64 years old, the presence of AAA rupture and hospital readmission at 30-day were predictors of post-operative mortality (AdjHR = 1.59 CI 95% 1.51–1.67; AdjHR = 1.49 CI 95% 1.36–1.62 and AdjHR = 1.92, CI 95% 1.84–2.00). The prevalence of diabetes was significantly lower in ruptured AAA compared to unruptured AAA (14.8% vs 20.9%, P < 0.001 for type 2 diabetes and 2.5% vs 4.0%, P < 0.001 for type 1 diabetes). Type 1 diabetes was significantly associated with post-operative mortality (AdjHR = 1.30 CI 95% 1.20–1.40). For type 2 diabetes, the association was not statistically significant (Adj HR = 0.96, CI 95% 0.92–1.01). Older age, AAA rupture and hospital readmission were associated with deaths that occurred after discharge from the first AAA repair. Type 1 diabetes was identified as a risk factor of post-operative mortality. This study highlights the complex association between diabetes and AAA and should encourage institutions to report long-term follow-up after AAA repair to better understand its impact.https://doi.org/10.1038/s41598-021-98893-x |
| spellingShingle | Juliette Raffort Fabien Lareyre Roxane Fabre Ziad Mallat Christian Pradier Laurent Bailly Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair Scientific Reports |
| title | Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair |
| title_full | Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair |
| title_fullStr | Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair |
| title_full_unstemmed | Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair |
| title_short | Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair |
| title_sort | nationwide study in france investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair |
| url | https://doi.org/10.1038/s41598-021-98893-x |
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