Imperial College London
Alternate

Mr Colin D Bicknell BM MD FRCS

Faculty of Medicine, Department of Surgery & Cancer

Clinical Reader in Vascular Surgery
 
 
 
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Contact

 

+44 (0)20 3312 6428colin.bicknell

 
 
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Location

 

1020Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Pouncey:2021:10.1016/j.ejvs.2021.05.029,
author = {Pouncey, AL and David, M and Morris, R and Ulug, P and Martin, G and Bicknell, C and Powell, J},
doi = {10.1016/j.ejvs.2021.05.029},
journal = {European Journal of Vascular and Endovascular Surgery},
pages = {367--378},
title = {Systematic review and meta-analysis of sex-specific differences in adverse events after open and endovascular intact abdominal aortic aneurysm repair: consistent worse outcomes for women},
url = {http://dx.doi.org/10.1016/j.ejvs.2021.05.029},
volume = {62},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: Previously, reports have shown women experience higher mortality than men after elective open (OAR) and endovascular (EVAR) repair of abdominal aortic aneurysm (AAA).With recent improvements in overall AAA repair outcomes, this study aimed to identify whether sex-specific disparity has been ameliorated by modern practice, and to define sex-specific differences in peri/post-operative complications and pre-operative status; factors which may contribute to poor outcome.Methods: Systematic review, meta-analysis and meta-regression of sex-specific differences in 30-day mortality and complications conducted according to PRISMA guidance (Prospero registrationCRD42020176398). Papers with ≥50 women, reporting sex-specific outcomes, following intact primary AAA repair, from 2000-2020 world-wide were included; separate analyses for EVAR and OAR. Data sources: Medline, Embase and CENTRAL databases 2005-2020 searched using ProQuest Dialog™. Results: 26 studies (371,215 men,65,465 women) included. Meta-analysis and meta-regression indicated sex-specific odds ratios(ORs) for 30-day mortality were unchanged from 2000-2020.Mortality risk was higher in women for OAR and more so for EVAR (OR [95%CI] 1.49 [1.37,1.61];1.86 [1.59,2.17] respectively) and remained following multivariable risk-adjustment. Transfusion, pulmonary complications and bowel ischemia were more common in women after OAR and EVAR (OAR: ORs 1.81 [1.60,2.04], 1.40 [1.28,1.53], 1.54 [1.36,1.75]; EVAR: ORs 2.18[2.08,2.29] 1.44 [1.17,1.77], 1.99 [1.51,2.62] respectively). Arterial injury, limb ischemia, renal and cardiac complications were more common in women after EVAR (ORs 3.02 [1.62-5.65], 2.13[1.48-3.06], 1.46 [1.22-1.72] and 1.19[1.03,1.37] respectively); the latter was associated with greater mortality risk on meta-regression. Conclusions: Increased mortality risk for women following AAA repair remains. Women had higher incidence of transfusion, pulmonary and bowel complications after EVAR and
AU  - Pouncey,AL
AU  - David,M
AU  - Morris,R
AU  - Ulug,P
AU  - Martin,G
AU  - Bicknell,C
AU  - Powell,J
DO  - 10.1016/j.ejvs.2021.05.029
EP  - 378
PY  - 2021///
SN  - 1078-5884
SP  - 367
TI  - Systematic review and meta-analysis of sex-specific differences in adverse events after open and endovascular intact abdominal aortic aneurysm repair: consistent worse outcomes for women
T2  - European Journal of Vascular and Endovascular Surgery
UR  - http://dx.doi.org/10.1016/j.ejvs.2021.05.029
UR  - https://www.sciencedirect.com/science/article/pii/S1078588421004457?via%3Dihub
UR  - http://hdl.handle.net/10044/1/90049
VL  - 62
ER  -
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