Survival After Endovascular Abdominal @entity449 Repair in a Population with a Low Incidence of XXXX .

@entity1 @entity449 @entity5 @entity955 @entity1011 @entity453 @entity204
BACKGROUND: Endovascular @entity449 repair (EVAR) is a prophylactic procedure, so the decision to operate should consider, as recent guidelines suggest, the life expectancy of the @entity1 . Several models for predicting life span have been already designed, but little is known about how intervened @entity1 evolve in Southern European Countries, where the incidence of @entity453 , the main cause of @entity204 among these subjects, is low. METHODS: We conducted a retrospective analysis of 176 consecutive @entity1 who underwent elective EVAR at the Vascular Surgery Department of the Hospital del Mar (Barcelona, Spain) during 2000-2014. Cox regressions were performed to identify preoperative factors associated with long-term survival after EVAR, and a risk model was developed. RESULTS: Three- and five-year survival rates were 73.9 and 53.9  %, respectively. During the follow-up, 72 deaths (40.9  %) were registered, @entity5 being the most frequent cause (41.7  %). Preoperative variables negatively associated with long-term survival were serum @entity1011 >= 150    mol/L (HR 2.5; 95  % CI 1.4-4.2), chronic obstructive pulmonary disease (HR 1.9; 95  % CI 1.2-3.1), @entity955 (HR 2.0; 95  % CI 1.2-3.4), and prior @entity5 history (HR 1.9; 95  % CI 1.2-3.1). Distal pulses present in both lower limbs were marginally associated with survival (HR 0.65; 95  % CI 0.4-1.07). The survival predictive model showed a good discrimination capacity (C statistic  =  0.703; 95  % CI 0.641-0.765). CONCLUSIONS: Long-term survival of @entity1 submitted to EVAR in our setting was worse than expected and markedly related to @entity5 . Our study suggests that predictive models for long-term survival after EVAR may be influenced by regional characteristics of the intervened population. This effect should be taken in consideration in the decision-making process of these @entity1 .
