The association between co-morbidity and mortality after abdominal aortic aneurysm endografting in patients ineligible for elective open surgery

Objective: to investigate whether co-morbidity affects mortality after endo vascular stenting in patients who are fit and unfit for open surgery. Methods: data were obtained from the EUROSTAR registry. The association bet ween co-morbidity and mortality was examined by Cox proportional hazards mo dels. Results: between 1994 and July 2000, 2862 patients underwent aneurysm stent ing; 381 were unfit for open surgery. The early/late mortality rates for pa tients fit for surgery, patients unfit for surgery and patients unfit for a naesthesia were 2.7/5.2%, 5.1/11.4% (p = 0.035/p < 0.0001) and 3.7/11.0% (N S/p = 0.016), respectively. The survival curves among patients with poor me dical condition were significantly worse than in those patients with a good medical condition (p = 0.001). The presence or absence of co-existing dise ases did not affect the mortality rate in patients unfit for open surgery. The age-adjusted mortality risks of patients fit for open surgery and pulmo nary disease or diabetes mellitus were 1.41 (1.02-1.95) and 1.75 (1.12-2.74 ), respectively. Conclusions: patients with co-morbidity had a significantly higher mortalit y after aortic endografting compared with patients fit for open singery. Co -morbidity did not increase mortality after endovascular abdominal repair i n patients unfit for open surgery. Endovascular repair of abdominal aortic aneurysm seems to have a limited benefit in patients unfit for open surgery .