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The effect of obesity on the outcome of thoracic endovascular aortic repair: a systematic review and meta-analysis

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单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Div Cardiothorac & Vasc Surg, Wuhan, Hubei, Peoples R China [2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Inst Gerontol,Dept Geriatr, Wuhan, Peoples R China [3]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Urol, Wuhan, Peoples R China
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关键词: Obesity Thoracic endovascular aortic repair Descending thoracic aortic pathologies Risk factor Meta-analysis

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Background. Obesity is a well-known predictor for poor postoperative outcomes of vascular surgery. However, the association between obesity and outcomes of thoracic endovascular aortic repair (TEVAR) is still unclear. This systematic review and metaanalysis was performed to assess the roles of obesity in the outcomes of TEVAR. Methods. We systematically searched the Web of Science and PubMed databases to obtain articles regarding obesity and TEVAR that were published before July 2023. The odds ratio (OR) or hazard ratio (HR) was used to assess the effect of obesity on TEVAR outcomes. Body mass index (BMI) was also compared between patients experiencing adverse events after TEVAR and those not experiencing adverse events. The Newcastle- Ottawa Scale was used to evaluate the quality of the enrolled studies. Results. A total of 7,849 patients from 10 studies were included. All enrolled studies were high-quality. Overall, the risk of overall mortality (OR = 1.49, 95% CI [1.02- 2.17], p = 0.04) was increased in obese patients receiving TEVAR. However, the associations between obesity and overall complications (OR = 2.41, 95% CI [0.84- 6.93], p = 0.10) and specific complications were all insignificant, including stroke (OR = 1.39, 95% CI [0.56-3.45], p = 0.48), spinal ischemia (OR = 0.97, 95% CI [0.64- 1.47], p = 0.89), neurological complications (OR = 0.13, 95% CI [0.01-2.37], p = 0.17), endoleaks (OR = 1.02, 95% CI [0.46-2.29], p = 0.96), wound complications (OR = 0.91, 95% CI [0.28-2.96], p = 0.88), and renal failure (OR = 2.98, 95% CI [0.92- 9.69], p = 0.07). In addition, the patients who suffered from postoperative overall complications (p < 0.001) and acute kidney injury (p = 0.006) were found to have a higher BMI. In conclusion, obesity is closely associated with higher risk of mortality after TEVAR. However, TEVAR may still be suitable for obese patients. Physicians should pay more attention to the perioperative management of obese patients.

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大类 | 3 区 生物学
小类 | 3 区 综合性期刊
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大类 | 3 区 生物学
小类 | 3 区 综合性期刊
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Q2 MULTIDISCIPLINARY SCIENCES
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Q2 MULTIDISCIPLINARY SCIENCES

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Div Cardiothorac & Vasc Surg, Wuhan, Hubei, Peoples R China
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