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Outcome analysis of the surgical team in open surgical repair of intact abdominal aortic aneurysm surgery

Title: Outcome analysis of the surgical team in open surgical repair of intact abdominal aortic aneurysm surgery
Authors: Piffaretti, Gabriele; Zammito, Alessandro; Guzzetti, Luca; Selmo, Gabriele; Binda, Simone; D’Onofrio, Dunia; Tozzi, Matteo; Franchin, Marco
Source: European Journal of Cardio-Thoracic Surgery ; volume 66, issue 3 ; ISSN 1873-734X
Publisher Information: Oxford University Press (OUP)
Publication Year: 2024
Description: OBJECTIVES To analyze how the experience of the surgical team went to impact the outcomes after open surgical repair (OSR) of intact abdominal aortic aneurysms (AAAs). METHODS This is a single-center, observational cohort study with retrospective analysis of all OR for intact AAA performed between 1 January 2010 and 31 December 2022. The primary outcome was survival at 30 days and in follow-up, and a composite outcome of mortality and major complication. The secondary outcome was freedom from aorta-related reintervention. All outcomes were stratified according to the experience of the operating team (surgeons and anesthesiology). RESULTS We analyzed 103 (7.2%) patients: 97 (94.2%) males and 6 (5.8%) females. The mean age was 76 ± 8 years (range, 55–93). The best possible team composition was present in 52 (50.5%) interventions. The follow-up index was 0.82 ± 0.18 (range, 0.6–1.0). Mean follow-up duration was 59 ± 43 months (range, 0–158). We observed no differences between teams in major complications (best, 17.3% vs mixed, 21.6%; OR: 0.4, P = 0.622), 30 days mortality (best, 0% vs mixed, 5.9%; OR: 7.6, P = 0.118) and composite outcome (best, 11.5% vs mixed, 17.6%; OR: 0.8, P = 0.416). Cox regression analysis identified the best possible team as a protective factor against the need for reintervention (hazard ratio: 0.2; 95% confidence interval: 0.06–0.88, P = 0.032). CONCLUSIONS In our experience, OR of AAA yielded satisfactory results in terms of safety and efficacy independently of the team’s experience. A more experienced team may protect against aorta-related reintervention.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ejcts/ezae319
DOI: 10.1093/ejcts/ezae319/58922832/ezae319.pdf
Availability: https://doi.org/10.1093/ejcts/ezae319; https://academic.oup.com/ejcts/advance-article-pdf/doi/10.1093/ejcts/ezae319/58922832/ezae319.pdf; https://academic.oup.com/ejcts/article-pdf/66/3/ezae319/59068216/ezae319.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.60844405
Database: BASE