Imperial College London

ProfessorJanetPowell

Faculty of MedicineDepartment of Surgery & Cancer

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 8846 7312j.powell

 
 
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Location

 

4N17Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ulug,
author = {Ulug, P and Powell, J and Warschkow, R and Von, Allmen RS},
journal = {European Journal of Vascular and Endovascular Surgery},
title = {Sex-specific differences in the management of descending thoracic aortic aneurysms: systematic review with meta-analysis},
url = {http://hdl.handle.net/10044/1/70278},
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - Objectives: To assess sex-specific differences in 30-day mortality, length of hospital stay and adverse neurological events following repair of intact degenerative descending thoracic aortic aneurysms, by either endovascular (TEVAR) or open repair.Data Sources: Medline, Embase and CENTRAL databases searched from 2005-2019 using ProQuest Dialog™.Review methods: The reviews were registered in PROSPERO (CRD42017020026) and performed according to PRISMA guidelines. The primary outcome was 30-day mortality with secondary outcomes of length of hospital stay and adverse neurological events. Forest plots with random effects meta-analysis to provide odds ratios (OR) were used for primary assessment.Results: For TEVAR, a total of seven studies were identified including 2758 women and 4674 men; of these six were eligible for the primary outcome of 30-day mortality including 1756 women and 2619 men. There were 94/1756 deaths in women and 82/2619 deaths in men, yielding a pooled 30-day mortality of 5% (95% c.i. 3 to 7) in women and 3% (95% c.i. 2 to 4) in men (OR 1.75 [95%CI 1.29; 2.38]). Length of hospital stay was longer in women, with standardised mean difference 0.3 days [95%CI 0.14; 0.47] (6 studies): meta-regression analysis did not identify the slightly older age of women as significant factor in these differences. Stroke rate was not different between the sexes. For open repair only a single study, with national coverage, was identified that reported 30-day mortality, which was similar in men and women. Conclusion: In the management of intact degenerative descending thoracic aortic aneurysms, 30-day mortality following TEVAR appears to be much higher in women than men with no reasons for this difference identified. For open repair however, there is a lack of contemporary evidence due to insufficient recent data.
AU - Ulug,P
AU - Powell,J
AU - Warschkow,R
AU - Von,Allmen RS
SN - 1078-5884
TI - Sex-specific differences in the management of descending thoracic aortic aneurysms: systematic review with meta-analysis
T2 - European Journal of Vascular and Endovascular Surgery
UR - http://hdl.handle.net/10044/1/70278
ER -