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Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis
PURPOSE: The purpose of this study was to compare the clinical outcomes of abdominal aortic graft infection (AGI) treated with removal of the graft vs. graft preservation. METHODS: The electronic databases PubMed, Embase, and Cochrane Library for studies that reported on AGI were searched. Observati...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Surgical Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613822/ https://www.ncbi.nlm.nih.gov/pubmed/37908379 http://dx.doi.org/10.4174/astr.2023.105.4.207 |
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author | Kim, Hyangkyoung Choi, Han Zo Kwon, Yujin Labropoulos, Nicos |
author_facet | Kim, Hyangkyoung Choi, Han Zo Kwon, Yujin Labropoulos, Nicos |
author_sort | Kim, Hyangkyoung |
collection | PubMed |
description | PURPOSE: The purpose of this study was to compare the clinical outcomes of abdominal aortic graft infection (AGI) treated with removal of the graft vs. graft preservation. METHODS: The electronic databases PubMed, Embase, and Cochrane Library for studies that reported on AGI were searched. Observational studies and case series of at least 10 cases that reporting on the prevalence, microbiology, and outcomes of AGI were included. RESULTS: Our search identified 23 studies that met our inclusion criteria, reporting on a total of 873 patients who underwent open surgical repair (OSR) or endovascular aneurysm repair (EVAR). Of these patients, 833 received graft removal, and 40 received graft preservation. The prevalence of AGI was reported to be 1.0% (95% confidence interval [CI], 0.5%–1.8%) after OSR and 0.4% (95% CI, 0%–1.1%) after EVAR. The pooled estimates of 1-year, 2-year, and 5-year mortality were 28.7% (95% CI, 19.4%–38.8%), 36.6% (95% CI, 24.6%–49.5%), and 51.8% (95% CI, 38.4%–65.1%) in the graft removal group and 16.1% (95% CI, 4.1%–32.2%), 18.5% (95% CI, 5.7%–35.1%), and 50.0% (95% CI, 31.6%–68.4%) in the graft preservation group. The 30-day mortality rate’s risk ratio (RR) for graft removal vs. preservation was 0.98 (95% CI, 0.40–2.38), while the 1-year mortality rate’s RR was 3.44 (95% CI, 1.60–7.42). CONCLUSION: The 30-day mortality rate of AGI treatment was found to be high, whether using graft removal or preservation. In selected patients, implementing antibiotics with graft preservation as an initial management may be helpful in reducing the mortality rate. |
format | Online Article Text |
id | pubmed-10613822 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Korean Surgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-106138222023-10-31 Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis Kim, Hyangkyoung Choi, Han Zo Kwon, Yujin Labropoulos, Nicos Ann Surg Treat Res Original Article PURPOSE: The purpose of this study was to compare the clinical outcomes of abdominal aortic graft infection (AGI) treated with removal of the graft vs. graft preservation. METHODS: The electronic databases PubMed, Embase, and Cochrane Library for studies that reported on AGI were searched. Observational studies and case series of at least 10 cases that reporting on the prevalence, microbiology, and outcomes of AGI were included. RESULTS: Our search identified 23 studies that met our inclusion criteria, reporting on a total of 873 patients who underwent open surgical repair (OSR) or endovascular aneurysm repair (EVAR). Of these patients, 833 received graft removal, and 40 received graft preservation. The prevalence of AGI was reported to be 1.0% (95% confidence interval [CI], 0.5%–1.8%) after OSR and 0.4% (95% CI, 0%–1.1%) after EVAR. The pooled estimates of 1-year, 2-year, and 5-year mortality were 28.7% (95% CI, 19.4%–38.8%), 36.6% (95% CI, 24.6%–49.5%), and 51.8% (95% CI, 38.4%–65.1%) in the graft removal group and 16.1% (95% CI, 4.1%–32.2%), 18.5% (95% CI, 5.7%–35.1%), and 50.0% (95% CI, 31.6%–68.4%) in the graft preservation group. The 30-day mortality rate’s risk ratio (RR) for graft removal vs. preservation was 0.98 (95% CI, 0.40–2.38), while the 1-year mortality rate’s RR was 3.44 (95% CI, 1.60–7.42). CONCLUSION: The 30-day mortality rate of AGI treatment was found to be high, whether using graft removal or preservation. In selected patients, implementing antibiotics with graft preservation as an initial management may be helpful in reducing the mortality rate. The Korean Surgical Society 2023-10 2023-09-27 /pmc/articles/PMC10613822/ /pubmed/37908379 http://dx.doi.org/10.4174/astr.2023.105.4.207 Text en Copyright © 2023, the Korean Surgical Society https://creativecommons.org/licenses/by-nc/4.0/Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Hyangkyoung Choi, Han Zo Kwon, Yujin Labropoulos, Nicos Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
title | Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
title_full | Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
title_fullStr | Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
title_full_unstemmed | Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
title_short | Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
title_sort | clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613822/ https://www.ncbi.nlm.nih.gov/pubmed/37908379 http://dx.doi.org/10.4174/astr.2023.105.4.207 |
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