te Riet ook genaamd Scholten, R.S. (2019) Factors associated with mortality in patients with vascular graft and endograft infection. thesis, Medicine.
Full text available on request.Abstract
Vascular graft and endograft infection (VGEI) is a rare but serious complication after vascular reconstruction with high risk of mortality. Symptoms can be nonspecific and no clear guidelines on diagnosis or management of VGEI are available yet. The primary aim of this study was to determine if there are any factors associated with mortality in patients with VGEI. Methods In this retrospective cohort study data of all the patients administered at the UMCG between 2008 and 2018 with vascular graft infection were collected. Clinical characteristics, diagnostic approaches, treatment strategies, and outcomes of vascular graft infection were evaluated. Multivariate Cox regression analysis was used to determine which factors were associated with mortality. Results In total 102 patients were included. The overall mortality rate was 38.2% with a median follow-up time of 92 weeks. The infection related mortality rate was 19.6%. Multivariate Cox regression analysis shows significant correlations between cardiac disease (hazard ratio 3.154, p=0.004), pulmonary disease (hazard ratio 2.458, p=0.027), immunosuppressive therapy (hazard ratio 4.656, p=0.000), graft location (hazard ratio 4.052, p=0.003) and CRP level (hazard ratio 1.006, p=0.003) and mortality. There was no significant correlation between conservative management and mortality (hazard ratio 0.954, p=0.905). Conclusion Cardiac disease, pulmonary disease, immunosuppressive therapy, graft location and CRP Level are associated with mortality in patients with VGEI. In future guidelines for management of VGEI, awareness of the use of immunosuppressive therapy might be considered. More detailed research on the outcome of different treatment modalities is necessary in order to make clear guidelines for treatment of VGEI.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Laan, dr M.J. van der and Reinders Folmer, drs. E.I. |
| Faculty: | Medical Sciences |
| Keywords: | Vascular Surgery, Endograft, Vascular graft, Mortality |
| Date Deposited: | 09 Jul 2020 11:40 |
| Last Modified: | 09 Jul 2020 11:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2741 |
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