Impact of Obesity on Outcomes after Open Surgical and Endovascular Abdominal Aortic Aneurysm Repair

Johnson, Odis; Sidawy, Anton N.; Scanlon, James M.; Walcott, Roger; Arora, Subodh; Macsata, Robyn A.; Amdur, Richard L.; Henderson, William G.

doi:10.1016/j.jamcollsurg.2009.10.011

Cited by 54 publications

(40 citation statements)

References 37 publications

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“…2 This study also reported that obesity was associated with increased wound complication rates for obese patients undergoing either OAR or EVAR. 2 Interestingly, this was reported as an ''all or none'' phenomenon, as no increasing rates of wound infection were noted between those patients with morbid obesity compared to moderate obesity. A linear relationship between increasing obesity and increasing rates of wound complications would have been expected, but such a correlation could not be demonstrated.…”

Section: Discussionmentioning

confidence: 64%

“…1,2 It has been reported that 30% of the US population met the clinical criteria for obesity in the year 2000, and current estimates indicate that by the year 2030 two thirds of the American population will be obese. 2,3 Obesity has clearly been linked to multiple medical problems such as hypertension (HTN), coronary artery disease (CAD), strokes, diabetes mellitus (DM), osteoarthritis, and pulmonary disorders. [4][5][6][7][8][9][10] In addition obesity has been proven to be an independent risk factor for adverse outcomes following general and cardiac surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

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Obesity is not an Independent Risk Factor for Adverse Perioperative and Long-Term Clinical Outcomes Following Open AAA Repair or EVAR

Park

Dargon

Binette

et al. 2011

Vasc Endovascular Surg

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Obesity is not an Independent Risk Factor for Adverse Perioperative and Long-Term Clinical Outcomes Following Open AAA Repair or EVAR

Park

Dargon

Binette

et al. 2011

Vasc Endovascular Surg

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“…Further, it is an important consideration for surgeons during patient selection and operative planning for abdominal aortic repair. For example while obese patients tolerate endovascular aneurysm repair better, in cases of open repair special attention should be paid to cardiac and infection risk [32]. Diabetes mellitus was recorded in only two cases of peripheral aneurysms, probably as an incidental finding.…”

Section: Comorbid Factorsmentioning

confidence: 99%

Pattern of aneurysms among young black Kenyans

Ogeng’o

Obimbo

Olabu

et al. 2011

Indian J Thorac Cardiovasc Surg

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Background Reports on pattern of aneurysms among young people are scanty. These data are important for informing preventive and management strategies. This retrospective study at Kenyatta National Hospital, Nairobi. Kenya describes the pattern of aneurysms among young black Kenyans. Patients and methods Records of in-patients, aged up to 40 years, with a diagnosis of aneurysm between January 1998 and December 2007 were examined for localization, presentation, investigations, comorbidities, age and gender distribution. Data were analyzed by SPSS version 13.0 for Windows, and presented in tables and bar charts. Results One hundred and fifteen files were analyzed. Most frequent site was abdominal aorta (32.2%). Of these, majority (59.4%) were infrarenal. Other commonly affected arteries included thoracic aorta (11.3%), posterior communicating (7.8%), femoral (8.7%), brachial (8.7%), common carotid (6.1%) and internal thoracic (5.2%). They presented as pulsatile, often painful masses, and with pressure symptoms. Diagnosis was confirmed by ultrasound and angiography. Common comorbidities were hypertension, smoking, Human Immunodeficiency Virus infection, alcohol, trauma, and connective tissue disorders. Mean age was 26.1 years and male: female ratio was 2.7:1. Conclusion Aneurysms are not uncommon in young Kenyans. They occur more commonly in males than females, and affect diverse vascular beds. Associated comorbidities comprise non communicable lifestyle factors, infection, inborn conditions and trauma. Lifestyle modification from early in life and control of infections are recommended.

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“…After endovascular aortic/aneurysm repair (EVAR), obesity (any class) is predictive of wound complications, but not predictive of other complications or death. 19 After controlling for age, gender and operation type, the mortality risk remained lowest in obese class I patients (odds ratio [OR] 0.63, P = 0.023), while the morbidity risk was highest in obese class III patients (OR 1.70, P = 0.0003), due to wound infection, thromboembolism and renal complications. 20,21 Insulin resistance Insulin resistance is the second key biological component of the metabolic syndrome ( Figure 1).…”

Section: General Clinical Implicationsmentioning

confidence: 99%

Biology of metabolic syndrome in a vascular patient

Vykoukal

2012

Vascular

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Metabolic syndrome is highly prevalent in vascular patients and has a significant impact on the outcomes of vascular interventions. It comprises of a set of metabolically driven risk factors, including truncal obesity, dyslipidemia, elevated blood pressure and elevated fasting blood glucose. Increased insulin resistance within the context of obesity and hypertension contributes to atherogenic dyslipidemia, hyperglycemia, and prothrombotic and proinflammatory states which lead to the adverse impact of metabolic syndrome on the response to injury and on atherosclerotic disease progression. This review focuses on the complex biology of metabolic syndrome and its relevance to management of vascular patients, including outcomes and implications for the coronary, cerebrovascular and lower-extremity vascular beds.

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Impact of Obesity on Outcomes after Open Surgical and Endovascular Abdominal Aortic Aneurysm Repair

Cited by 54 publications

References 37 publications

Obesity is not an Independent Risk Factor for Adverse Perioperative and Long-Term Clinical Outcomes Following Open AAA Repair or EVAR

Obesity is not an Independent Risk Factor for Adverse Perioperative and Long-Term Clinical Outcomes Following Open AAA Repair or EVAR

Pattern of aneurysms among young black Kenyans

Biology of metabolic syndrome in a vascular patient

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