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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Autores principales:	Juliette Raffort, Fabien Lareyre, Roxane Fabre, Ziad Mallat, Christian Pradier, Laurent Bailly
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dea74739716f48bfa5baaf832ccb9c10
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spelling	oai:doaj.org-article:dea74739716f48bfa5baaf832ccb9c102021-12-02T17:37:40ZNationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair10.1038/s41598-021-98893-x2045-2322https://doaj.org/article/dea74739716f48bfa5baaf832ccb9c102021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98893-xhttps://doaj.org/toc/2045-2322Abstract 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.Juliette RaffortFabien LareyreRoxane FabreZiad MallatChristian PradierLaurent BaillyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	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_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_sort	nationwide study in france investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dea74739716f48bfa5baaf832ccb9c10
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Nationwide study in France investigating the impact of diabetes on mortality in patients undergoing abdominal aortic aneurysm repair

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