Quality of Life after Endovascular and Open AAA Repair. Results of a Randomised Triala☆

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Abstract

Aim. To compare the quality of life (QoL) in the first postoperative year after elective endovascular abdominal aortic aneurysm repair (EVAR) and open repair (OR) in a randomised study.

Methods. In the Dutch Randomised Endovascular Aneurysm Management (DREAM) trial, patients are randomly allocated to EVAR or OR. QoL questionnaires (SF-36 and EuroQoL-5D) were sent to all patients preoperatively (PREOP) and at five time points in the first postoperative year (3W, 6W, 3M, 6M and 12M). Between November 1999 and August 2002, 153 patients (141 male; 12 female) were randomised (78 EVAR and 75 OR; one crossover from OR to EVAR). The EuroQoL-5D scores and the eight domains of the SF-36 for the two groups were compared using the Mann–Whitney test. Changes over time were analysed using the Wilcoxon sign test.

Results. There were no statistically significant differences in baseline characteristics (age, gender and SVS risk factors). The preoperative QoL scores of the study group were similar to the QoL scores of the general population of the same age. After 3W the OR group showed a significant decrease on the EuroQol-5D (p=0.022) and in six of the eight SF-36 domains. The EVAR group also showed a significant decrease on the EuroQol-5D (p=0.004) and in 5 of the 8 domains of the SF-36. At 6W the EuroQol-5D had recovered to baseline in the OR group and the decreased domains of the SF-36 had partially recovered. In the EVAR group the EuroQol-5D and three of the five decreased SF-36 domains, had returned to baseline. From 6M on, the OR group reported a significantly higher score on the EuroQoL-5D than the EVAR group (p=0.045 (6M) and p=0.001 (12M)).

Conclusion. In the early postoperative period there is a small, yet significant QoL advantage for EVAR compared to OR. At 6 months and beyond, patients reported better QoL after OR than after EVAR.

Keywords

Quality of life
EVAR
Open AAA repair
Randomised trail
DREAM-trial

Cited by (0)

☆

Presented at the ESVS, 5–7 September 2003, Dublin, Ireland.

a

DREAM-trial participants. The Netherlands: Catharina Hospital, Eindhoven, J Buth, AV Tielbeek; University Hospital Groningen, Groningen, ELG Verhoeven, T. Prins; St Elisabeth Hospital,Tilburg, JF Hamming, LEH Lampmann, University Medical Center Maastricht, Maastricht, GWH Schurink, M. de Haan; Academic Medical Center Amsterdam, Amsterdam, R Balm, JA Reekers; Maxima Medical Center loc. Veldhoven, Veldhoven, MHM Bender, H Pasmans; University Medical Center Leiden, Leiden, MJT Visser, E van der Linden; University Medical Center Utrecht, Utrecht, JD Blankensteijn, WPThMMali; Medical Center Rijnmond Zuid, Rotterdam, AAEA de Smet, D Vroegindeweij, Rijnstate Hospital, Arnhem, SMM van Sterkenburg, GB ten Haken; Martini Hospital, Groningen, JHB Boomsma, HR van Dop; Medical Center Haaglanden, loc. Westeinde's, Gravenhage, JCA de Mol van Otterloo, TPW de Rooij; Erasmus Medical Center, Rotterdam, MRHM van Sambeek, P Pattynama; Leyenburg Hospital's, Gravenhage, CMA Bruijninckx, H van Overhagen; St Franciscus Gasthuis, Rotterdam, AC van der Ham, JJIM van der Velden; Academic Medical Center VU, Amsterdam, W Wisselink, FG van den Berg; Albert Schweitzer Hospital, Dordrecht, RP Tutein Nolthenius, TR Hendriksz; OLVG, Amsterdam, AC Vahl, C de Vries; Meander Medical Center, Amersfoort, AJC Mackaay; Bronovo Hospital's, Gravenhage, HJ Smeets; Vlietland Hospital, Schiedam, LMC van Dortmont, Deventer Hospital, Deventer, BHP Elsman; Hospital Bernhoven, Oss, TM Smits; Jeroen Bosch Hospital's, Hertogenbosch, RMM van Loenhout, MJ Rutten; Atrium Medical Center, Heerlen, JAW Teijink, HF Odink; Oosterschelde Hospital, Goes, EN Yilmaz; Maxima Medical Center Eindhoven, Eindhoven, G den Butter. Belgium: University Hospital Antwerpen, Antwerpen, J Poniewierski; University Medical Center Gent, Gent, FEG Vermassen; St Jozef Hospital, Turnhout, P Stabel; St Trudo Hospital, St Truiden, F van Elst.

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