Patients With Cancer Face Greater Risks From Abdominal Aneurysm Repair

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Elective abdominal aortic aneurysm repair in patients with a cancer diagnosis is associated with several poor postoperative outcomes, according to a newly published study from researchers at the University of Missouri School of Medicine. Roush et al reported their findings in the Journal of Vascular Surgery.

A ruptured abdominal aortic aneurysm is the 15th-leading cause of death in the United States, which is why these defects are often surgically repaired when discovered. Smoking is a risk factor for both abdominal aortic aneurysm and cancer.

“Due to the strong association between abdominal aortic aneurysm and cancer, we wanted to determine if [patients with cancer] who underwent elective [aneurysm] repair had a greater risk of in-hospital death, cardiac complications, infection, and respiratory problems compared to patients without a cancer diagnosis,” said senior author Jonathan Bath, MD, Assistant Professor of Surgery.

Key Findings

Dr. Bath’s team analyzed data from the Cerner Health Facts database. Out of 8,663 patients who underwent abdominal aortic aneurysm procedures, 270 were identified with a cancer diagnosis. The researchers found patients with cancer who underwent such procedures were associated with a hospital stay longer than 10 days, renal failure, respiratory problems, and infection. 

“We did not find that a cancer diagnosis increased the risk of in-hospital mortality, cardiac complications or stroke,” Dr. Bath said. “But cancer patients did experience more vascular complications such as bleeding, thrombosis, or the need to undergo a repeat procedure.”

The researchers also found male patients with a cancer diagnosis had higher odds of a prolonged length of stay, infection, and respiratory failure than women with a cancer diagnosis, but there were far fewer women in the sample, making this finding less robust.

“Cancer diagnosis had no effect on mortality at 30 and 90 days unless the patient had lung cancer,” Dr. Bath said. “The mortality rate at the end of the study period was significantly higher in patients with a diagnosis of cancer than not, but many cancers will ultimately lead to patient death despite treatment. These findings illustrate the importance of careful patient selection when determining the need and type of aneurysm repair.” 

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