{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:57Z","timestamp":1740126837289,"version":"3.37.3"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund In dieser retrospektiven Propensity-Score-gematchten Studie sollten die perioperative Letalit\u00e4t und das Langzeit\u00fcberleben bis zu 9 Jahre nach endovaskul\u00e4rer (EVAR) und offener (OAR) Versorgung von Patienten mit rupturiertem Bauchaortenaneurysma (rAAA) in Deutschland anhand von Krankenkassendaten der AOK-Gesundheit dargestellt werden.<\/jats:p><jats:p>\n          Material und Methodik Es wurden 2170 Patienten, die zwischen dem 01.01.2010 und 31.12.2016 mit einem rAAA innerhalb 24\u00a0h nach station\u00e4rer Aufnahme versorgt wurden und Bluttransfusionen erhielten, in die Studie aufgenommen und bis zum 31.12.2018 nachverfolgt. Zur besseren Vergleichbarkeit von EVAR und OAR erfolgte ein 1:1-Propensity-Score-Matching der Patienten nach Alter, Geschlecht und Vorerkrankungen \u00fcber das R-Programm (Stiftung f\u00fcr Statistisches Rechnen, Wien, \u00d6sterreich) mit 624 Paaren.<\/jats:p><jats:p>\n          Ergebnisse Im nicht adjustierten Kollektiv wurden 29,1% (631\/2170) der Patienten mit EVAR und 70,9% (1539\/2170) mit OAR versorgt. EVAR-Patienten hatten eine signifikant h\u00f6here Rate an Komorbidit\u00e4ten. Nach Adjustierung wiesen EVAR-Patienten das signifikant bessere perioperative \u00dcberleben (EVAR 35,7%; OAR 51,0%; p\u00a0=\u00a00,000) auf. Bei 80,4% der EVAR-Patienten und 80,3% der OAR-Patienten sind perioperative Komplikationen aufgetreten (p\u00a0=\u00a01,000). Am Ende des Follow-ups \u00fcberlebten Kaplan-Meier-gesch\u00e4tzt 15,2% der Patienten bei EVAR vs. 19,5% bei OAR (p\u00a0=\u00a00,027). In der multivariaten Cox-Regressionsanalyse hatten OAR, das Alter \u2265\u00a080 Jahre, ein Diabetes mellitus Typ 2 und die Niereninsuffizienz in den Stadien 3\u20135 einen negativen Einfluss auf das Gesamt\u00fcberleben. Werktags operierte Patienten hatten eine signifikant niedrigere perioperative Letalit\u00e4t (perioperative Letalit\u00e4t werktags 40,6% vs. Wochenende 53,4%; p\u00a0=\u00a00,000) und ein Kaplan-Meier-gesch\u00e4tzt besseres Gesamt\u00fcberleben\n          als Patienten des Wochenendes.<\/jats:p><jats:p>\n          Schlussfolgerung Es wurde ein signifikant besseres perioperatives \u00dcberleben und Gesamt\u00fcberleben bei EVAR beobachtet. Der perioperative \u00dcberlebensvorteil von EVAR ergab sich ebenfalls bei den \u00fcber \u2265\u00a080-j\u00e4hrigen Patienten. Das weibliche Geschlecht hatte auf die perioperative Sterblichkeit und auf das Gesamt\u00fcberleben keinen signifikanten Einfluss. Am Wochenende versorgte Patienten hatten ein signifikant schlechteres perioperatives \u00dcberleben verglichen mit Patienten, die unter der Woche versorgt wurden, was bis zum Ende des Follow-ups anhielt. Inwieweit dies von der Klinikstruktur abh\u00e4ngig war, konnte nicht \u00fcberpr\u00fcft werden.<\/jats:p>","DOI":"10.1055\/a-2044-0780","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T23:19:22Z","timestamp":1680045562000},"page":"398-407","source":"Crossref","is-referenced-by-count":0,"title":["Langzeitergebnisse nach endovaskul\u00e4rer und offener Versorgung des rupturierten Bauchaortenaneurysmas \u2013 eine Propensity-Score-Analyse"],"prefix":"10.1055","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2801-3087","authenticated-orcid":false,"given":"Yuliya","family":"Svidlova","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gef\u00e4\u00df- und Endovaskularchirurgie, Goethe-Universit\u00e4t Frankfurt am Main, Frankfurt am Main, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmin","family":"Epple","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gef\u00e4\u00df- und Endovaskularchirurgie, Goethe-Universit\u00e4t Frankfurt am Main, Frankfurt am Main, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neelam","family":"Lingwal","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Biostatistik und mathematische Modellierung, Goethe-Universit\u00e4t Frankfurt am Main, Frankfurt am Main, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Schmitz-Rixen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gef\u00e4\u00df- und Endovaskularchirurgie, Goethe-Universit\u00e4t Frankfurt am Main, Frankfurt am Main, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dittmar","family":"B\u00f6ckler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gef\u00e4\u00dfchirurgie und Endovaskul\u00e4re Chirurgie, Universit\u00e4tsklinikum Heidelberg, Heidelberg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhart T.","family":"Grundmann","sequence":"additional","affiliation":[{"name":"Deutsches Institut f\u00fcr Gef\u00e4\u00dfmedizinische Gesundheitsforschung (DIGG gGmbH) der DGG, Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ejvs.2018.09.020","article-title":"Editor\u2019s Choice \u2013 European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms","volume":"57","author":"A Wanhainen","year":"2019","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/j.jvs.2021.03.019","article-title":"Time-to-event data meta-analysis of late outcomes of endovascular versus open repair for ruptured abdominal aortic aneurysms","volume":"74","author":"N Kontopodis","year":"2021","journal-title":"J Vasc Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.jvs.2019.10.074","article-title":"Society for Vascular Surgery Vascular Quality Initiative. 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