Levent Altınay, Elif Coşkun Sungur, İlker İnce

Endovasküler aort onarımı yapılan hastalarda nörolojik sonuçlar ile hastane mortalitesi arasındaki ilişki

Amaç Torakoabdominal aort patolojilerinde EVAR/TEVAR sonuçlarımızı ve post-prosedural nörolojik olaylar ile hastane mortalitesi arasındaki ilişkiyi sunmak. Gereç ve yöntem Kasım 2016 – Mayıs 2021 arasında EVAR/TEVAR işlemi uygulanmış hastalar bu retrospektif çalışmaya alındı. İşlem öncesi herhangi bir nörolojik olay öyküsü olan hastalar çalışmaya alınmadı. Post-prosedural erken nörolojik komplikasyonların oluşuna göre hastalar iki gruba ayrıldı. Bulgular Toplam 60 hasta değerlendirildi. Grup 1 nörolojik komplikasyon olmayan 37 (%78.7) hasta, Grup 2 post-prosedural nörolojik komplikasyon olan 10 (%21.3) hastadan oluştu. Yoğunbakımda kalış süresi Grup 2’de anlamlı derecede uzundu (1.7 ± 2.0 gün Group 1 vs 6.2 ± 5.1 gün Group 2, p=0.021). genel mortalite oranı %19.1 (47 hastada 9) idi. Grup 2 mortalite oranı anlamlı derecede yüksekti (37 hastada 2 (%5.4) Group 1’de vs 10 hastada 7 (%70) Group 2’de, p=0.001). Amerikan Anesteziyolojistler Birliği fiziksel sınıflama skoru Grup 2’de anlamlı derecede yüksekti (3.5 ± 0.6 Group 1 vs 4.1 ± 0.3 Group 2, p=0.016). En sık erken postprosedural nörolojik komplikasyon bilinç olmamasıydı. Sonuç Erken postprosedural nörolojik komplikasyon oluşması, TEVAR ve EVAR prosedürlerinin hastane mortalitesini artmasına katkı yapmaktadır.

Anahtar Kelimeler:

EVAR, TEVAR, nörolojik komplikasyon, hastane mortalitesi

The relation between neurological outcomes and in-hospital mortality rates of endovascular aortic repair patients

Aim To represent our results of EVAR/TEVAR procedures for thoracoabdominal aortic pathologies and the relation between the post-procedural neurological adverse events and in-hospital mortality. Material and Method Patients who underwent EVAR/TEVAR procedures between November 2016 and May 2021 included in this retrospective study. Patients with a history of any cerebrovascular event before the intervention were excluded. Patients divided into two groups according to occurrence of any early neurological complications. Results A total of 60 patients who underwent EVAR/TEVAR procedures were evaluated. Group 1 included 37 (78.7%) patients who had no neurological complication. Group 2 included 10 (21.3%) patients who had a postoperative neurological complication. The intensive care unit stay time was significantly longer in Group 2 than Group 1 (1.7 ± 2.0 days in Group 1 vs 6.2 ± 5.1 days in Group 2, p=0.021). Overall mortality rate was 19.1% (9 of 47 patients). The mortality rate of the Group 2 was significantly higher than Group 1 (2 of 37 (5.4%) patients in Group 1 vs 7 of 10 patients (70%) in Group 2, p=0.001). American Society of Anesthesiologists physical classification score was significantly higher in Group 2 than Group 1 (3.5 ± 0.6 in Group 1 vs 4.1 ± 0.3 in Group 2, p=0.016). The most common early postoperative neurological complication was lack of recovery of consciousness (no postoperative consciousness). Conclusion The occurrence of any postoperative neurological adverse event has an additive effect to the in-hospital mortality rate of TEVAR and EVAR procedures.

Keywords:

EVAR, TEVAR, neurological deficit, in-hospital mortality,

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