Table 2. Postoperative outcome in chronic obstructive pulmonary disease (COPD) and non-COPD patients with abdominal aortic aneurysms (AAA).
| Study (published year) | Study type | Male (%) | Age | Region | AAA | 30-d mortality | Long term mortality | 30-d morbidity | Long-term morbidity | Comment |
|---|---|---|---|---|---|---|---|---|---|---|
| Crawford et al. (1986) | PBS | 85.1 | 28–85 | US | 101 elective open COPD: 34 Non-COPD: 67 | 30-d 1 (2.9%) 7 (10.4%) (P = 0.2611) | 30-d Dialysis 2 (5.9%) 5 (7.5%) (P = 1.000) | |||
| Katz et al. (1994) | PBS | 82 | ≥50 | US | 8185 open COPD: 1792 Non-COPD: 6393 | In-hospital 142 (7.9%) 473 (7.4%) (P = 0.6) | Elective: 8185 Rupture: 1829 | |||
| Koskas et al. (1997) | PS | 89.9 | 42–92 | France | 158 elective open COPD: 51 Non-COPD: 107 | 5.3-y (P < 0.01) | ||||
| Eskandari et al. (oxygen) | CCS | 76.9 | 72m | US | 65 elective open COPD: 14 Non-COPD: 51 | In-hospital 4 (28.6%) 18 (35.3%) | Oxygen dependent COPD | |||
| Cuypers et al. (2000) | PBS | 91.8 | 70m | Netherland | 1871 elective EVAR COPD: 683 Non-COPD: 1188 | 1.5-y Conversion 27 (4.0%) 22 (1.9%) OR 2.22 (1.12–4.37)* | ||||
| Axelrod et al. (2001) | PBS | 100 | 69m | US | ||||||
| Rupture | 52 open rupture COPD: 20 Non-COPD: 32 | 30-d 8 (40.0%) 2 (6.3%) | ||||||||
| No-rupture | 1001 elective open COPD: 244 Non-COPD: 757 | 30-d 9 (3.7%) 28 (3.7%) OR 1.1(P = 0.81)* | 30-d OR 2.3 (P = 0.07)*In ventilation >96 h | |||||||
| Huber et al. (2001) | PBS | 79.7 | 72m | US | 16450 elective open | In-hospital OR 1.0; 95%CI 0.9–1.3 (P = 0.67)* | In-hospital OR 1.3; 95% CI 1.1–1.4 (P < 0.0001)* | |||
| Biancari et al. (2002) | PBS | 90.4 | 66m | Finland | 208 EVAR COPD: 54 Non-COPD: 154 | 15-y (P = 0.001) RR 1.76, 95% CI 1.22–2.44 (P = 0.002)* | Elective: 167; Emergency for no rupture: 9; Emergency for rupture: 32 | |||
| Piper et al. (2003) | PBS | 68.4 | 72m | US | 147 open rupture COPD: 35 Non-COPD: 112 | In-hospital 9 (25.7%) 42 (37.5%) | ||||
| Tassiopoulos et al. (2004) | PBS | 81.7 | 71m | US | 115 elective open COPD: 22 Non-COPD: 93 | In-hospital Ventilator time (P = 0.12) ICU stay (P = 0.015) Postoperative ileus (NS) Hospital stay (P = 0.03) | ||||
| Hertzer et al. (2005) | PBS | 86 | ≥47 | US | 855 elective open COPD: 53 Non-COPD: 802 | 30-d OR 3.8; 95% CI 1.2–11.6 (P = 0.036) OR 5.1; 95% CI 1.6–16.5 (P = 0.0006)* | 15-y HR 1.55; 95% CI 1.11–2.17 (P = 0.016) HR 1.6 95% CI 1.1–2.2 (P = 0.012)* | HR: any death (postoperative and late death) | ||
| Hua et al. (2005) | PS | 81.8 | 72m | US | 1042 elective EVAR and open COPD: 221 Non-COPD: 821 | 30-d OR 1.67; 95%CI 0.81–3.44 (P = 0.17) | 30-d OR 1.42; 95CI% 1.03–1.94 (P = 0.03) OR 1.32; 95%CI 0.91–1.91 (P = 0.15)* | EVAR: 460 Open: 582 | ||
| Schouten et al. (2006) | PBS | 86 | 70m | Netherland | 500 elective open COPD: 31 Non-COPD: 469 | 30-d OR 1.83; 95% CI 0.86–3.87 (P = 0.12) OR 1.50; 95% CI 0.63–3.58 (P = 0.36)* | 30-d OR 1.91; 95% CI 0.93–3.93(P = 0.08) OR 1.81; 0.85–3.89 (P = 0.13)* | |||
| Zarins et al. (2006) | PS | 88.3 | 74m | US | 923 elective EVAR COPD: 90 Non-COPD: 833 | 5-y HR 1.84 (P < 0.0001)*AAA related death HR 1.75 (P = 0.18)* | 5-y AAA rupture HR 0.987 (P = 0.98)*Conversion HR 1.07 (P = 0.18)* | |||
| Anain et al. (2007) | PBS | 75 | 57–89 | US | 40 EVAR and open rupture COPD: 17 Non-COPD: 23 | 30-d 5 (29.4%) 4 (17.4%) | EVAR: 30 Open: 10 | |||
| Bonardelli et al. (2007) | PBS | 93.5 | NA | Italy | 1111 elective open COPD: 428 Non-COPD: 683 | 30-d 14 (3.3%) 16 (2.3%) (P = 0.35) | 5-y (P < 0.001) (P = 0.014)* | |||
| Berge et al. (2008) | PBS | 82.9 | 71m | US | 1041 EVAR and open COPD: 144 Non-COPD: 897 | 30-d Open OR 1.2; 95% CI 0.7–2.1 (P = 0.48)* | 20-y OR 1.5; 95% CI 1.17–1.92 (P = 0.001)* | EVAR: 136 Open rupture: 299; Open no rupture: 606 | ||
| Botha et al. (2008) | PBS | 80.6 | 76m | Australia | 62 open rupture COPD: 17 Non-COPD: 45 | In-hospital 8 (47.1%) 12 (26.7%) OR 6.7; 95% CI 1.1–41.3 (P = 0.04)* | ||||
| Park et al. (2008) | CCS | 88.6 | 76m | US | 342 elective EVAR COPD: 137 Non-COPD: 205 | In-hospital 3 (2.2%) 4 (2.0%) (P = 1.0) | In-hospital 18 (40.1%) 18 (43.9%) | Long-term mortality: COPD (CHF: 3; MI:1;; RC: 14); Non-COPD (CHF: 2; MI: 2; RC: 14) | ||
| Abedi et al. (2009) | PBS | 82.3 | 74m | US | 3662 elective EVAR COPD: 700 Non-COPD: 2962 | 30-d OR 1.31 (P < 0.05)*in postoperative transfusion 4u. w/in 72 h of procedure OR 2.28 (P < 0.05)* | ||||
| Antonello et al. (2009) | PBS | 79.6 | 47–91 | Italy | 103 open rupture COPD: 35 Non-COPD: 68 | 30-d 15 (42.9%) 15 (22.1%) (P = 0.028) | ||||
| Beck et al. (2009) | PS | 71 | 74m | US | ||||||
| Open | 748 elective open COPD: 269 Non-COPD: 479 | 1-y P = 0.002 HR 3.6; 95% CI 1.9–7.0* | ||||||||
| EVAR | 639 elective EVAR COPD: 249 Non-COPD: 390 | 1-y P = 0.007 | ||||||||
| Holst et al. (2009) | PBS | 86 | 76m | Sweden | 90 EVAR rupture COPD: 28 Non-COPD: 62 | 30-d RR 4.3; 95%CI 1.7–11.0 (P = 0.003)* | ||||
| Mastracci et al. (2010) | PS | 88 | 75m | US | 412 elective EVAR COPD: 155 Non-COPD: 257 | 6-y 106 (68.4%) 136 (52.9%) HR1.6; 95% CI 1.3–2.1 (P = 0.002) HR 1.6; 95% CI 1.2–2.2 (P = 0.001)* | ||||
| Geisbüsch et al. (2011) | PBS | 85 | >80 | US, Germany | 299 elective EVAR COPD: 90 Non-COPD: 209 | 6.8-y HR 1.56; 95% CI 1.03–2.35 (P = 0.032)* | ||||
| Twine et al. (2011) | PBS | 92.7 | 55–88 | UK | 178 elective EVAR COPD: 33 Non-COPD: 145 | 3-y HR 0.42; 95% CI 0.25–0.72 (P = 0.002) | ||||
| Wisniowski et al. (2011) | PBS | 87.3 | 73m | Australia | 197 elective EVAR COPD: 39 Non-COPD: 158 | 3-y (P = 0.027) (P = 0.035)* | ||||
| Gupta et al. (2012) | PBS | 72.5 | 66–78 | US | 598 elective open COPD: 122 Non-COPD: 476 | 30-d 11 (9.0%) 16 (3.4%) OR 3.17; 95% CI 1.39–7.25* | 30-d Major complication: 48 (39.3%) 132 (27.7%) (P = 0.01) | |||
| Ohrlander et al. (2012) | PS | 86 | 53–89 | Sweden | 233 elective EVAR COPD: 95 Non-COPD: 138 | 5-y 38 (40.0%) 39 (28.3%) (P = 0.058) | Long-term mortality COPD (grade ≥2) (P = 0.040) COPD (grade ≥3) (P = 0.016) PaO2 < 8.0 kPa or COPD, grade ≥3 (P = 0.005) HR 2.06; 95% CI 1.24–3.42 (P = 0.005)* | |||
| De Martino et al. (2013) | PBS | 79.3 | 67–82 | US | 2367 elective EVAR and open | |||||
| Untreated | 1897 elective EVAR and open COPD: 336 Non-COPD: 1562 | 5-y OR 1; 95% CI 0.7–1.3* | EVAR: 1303 Open: 594 Untreated COPD | |||||||
| Medical | 1936 elective EVAR and open COPD: 374 Non-COPD: 1562 | 5-y OR 1.3; 95% CI 1.0–1.8* | EVAR: 1355 Open: 579 Medication COPD | |||||||
| Oxygen | 1659 elective EVAR and open COPD: 97 Non-COPD: 1562 | 5-y OR 3.0; 95% CI 2.0–4.5* | EVAR: 1165 Open: 493 Oxygen dependent COPD | |||||||
| Stone et al. (2013) | PS | 78.1 | 72m | US | ||||||
| Medical | 3320 elective EVAR and open COPD: 1082 Non-COPD: 2238 | 5-y HR 1.22; 95% CI 1–1.5 (P = 0.02)* | EVAR: 2043 Open: 1412 Medical COPD | |||||||
| Oxygen | 2373 elective EVAR and open COPD: 135 Non-COPD: 2238 | In-hospital OR 2.02; 95% CI 1.0–4.0 (P = 0.04)* | 5-y HR 3.02; 95%C 2.2–4.1 (P < 0.001)* | Oxygen dependent COPD | ||||||
| Raux et al. (2014) | CCS | 76.6% | 73m | US and France | 563 elective FEVAR and open | 30-d OR 3.3; 95%CI 1.7–6.7 (P = 0.0008)* |
PBS: population based screening; CCS: case control study; PS: prospective study; COPD: chronic obstructive pulmonary disease; EVAR: endovascular aortic repair; OR: odd ratio; RR: relative risk; HR: hazard rate; CI: confidence interval; SDD: same day discharge; POD: postoperative discharge; CHF: congestive heart failure; MI: myocardial infarction; RC: respiratory complications; ICU: intensive care unit; NS: not significant; NA: not available; O2: oxygen; m mean; *adjusted data available.
Reference in supplemental files.