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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
- Authors
- Kim; Hyangkyoung; Choi; Han Zo; Kwon; Yujin; Labropoulos; Nicos
- Ewha Authors
- 김향경
- SCOPUS Author ID
- 김향경
- Issue Date
- 2023
- Journal Title
- Annals of Surgical Treatment and Research
- ISSN
- 2288-6575
- Citation
- Annals of Surgical Treatment and Research vol. 105, no. 4, pp. 207 - 218
- Keywords
- Aortic aneurysm; Device removal; Prosthesis-related infection; Treatment outcome
- Publisher
- Korean Surgical Society
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- 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. Copyright © 2023, the Korean Surgical Society.
- DOI
- 10.4174/astr.2023.105.4.207
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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