Patient-Reported Outcomes of Yearly Imaging Surveillance in Patients Following Endovascular Aortic Aneurysm Repair

A C M Geraedts; S Mulay; C B Terwee; A C Vahl; H J M Verhagen; Ç Ünlü; D T Ubbink; M J W Koelemay; R Balm

doi:10.1016/j.avsg.2021.11.003

Patient-Reported Outcomes of Yearly Imaging Surveillance in Patients Following Endovascular Aortic Aneurysm Repair

Ann Vasc Surg. 2022 May:82:221-227. doi: 10.1016/j.avsg.2021.11.003. Epub 2021 Dec 10.

Authors

A C M Geraedts¹, S Mulay², C B Terwee³, A C Vahl⁴, H J M Verhagen⁵, Ç Ünlü⁶, D T Ubbink², M J W Koelemay², R Balm⁷

Affiliations

¹ Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: [email protected].
² Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.
³ Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁴ Department of Surgery, OLVG, Amsterdam, The Netherlands.
⁵ Department of Vascular Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
⁶ Department of Vascular Surgery, Noordwest Hospital, Alkmaar, The Netherlands.
⁷ Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: [email protected].

PMID: 34902477
DOI: 10.1016/j.avsg.2021.11.003

Abstract

Little is known about the impact of standardized imaging surveillance on anxiety levels and well-being of patients after endovascular aortic aneurysm repair (EVAR). We hypothesize that patient anxiety levels increase just before receiving the imaging results compared with standard anxiety levels.

Methods: Prospective cohort study from November 2018 to May 2020 including post-EVAR patients visiting the outpatient clinics of 4 Dutch hospitals for imaging follow-up. The Patient-Reported Outcomes Measurement Information System (PROMIS) was used. Patients completed the PROMIS Anxiety v1.0 Short Form (SF) 4a, PROMIS-Global Health Scale v1.2, and PROMIS-Physical Function v1.2 SF8b at 2 time points: prior to the result of the imaging study (T1: pre-visit) and 6-8 months later (T2: reference measurement). Mean T-scores at T1 were compared to T2, and T2 to the general 65+ Dutch population.

Results: Altogether 342 invited patients were eligible, 214 completed the first questionnaire, 189 returned 2 completed questionnaires and 128 patients did not participate. Out of 214 respondents, 195 were male (91.1%) and the mean (standard deviation) age was 75.2 (7.0) years. There were no significant differences between T1 and T2 in anxiety levels (0.48; 95% confidence interval[CI] -0.42-1.38), global mental health (0.27; 95% CI -0.79-0.84), global physical health (0.10; 95% CI -0.38-1.18) and physical function (0.53; 95% CI -0.26-1.32). Compared with the 65+ Dutch population, at T2 patients experienced more anxiety (3.8; 95% CI 2.96-5.54), had worse global physical health (-3.2; 95% CI -4.38 - -2.02) and physical function (-2.4; 95% CI -4.00 - -0.80). Global mental health was similar (-1.0; 95% CI -2.21 - 0.21).

Conclusions: Post-EVAR patients do not experience more anxiety just before receiving surveillance imaging results than outside this period, but do suffer from more anxiety and worse physical outcomes than the 65+ Dutch population.

Keywords: Aortic Aneurysm, Abdominal; Endovascular Procedures.; Patient-reported outcomes.

MeSH terms

Aged
Aortic Aneurysm, Abdominal* / diagnostic imaging
Aortic Aneurysm, Abdominal* / etiology
Aortic Aneurysm, Abdominal* / surgery
Blood Vessel Prosthesis Implantation* / adverse effects
Endovascular Procedures* / adverse effects
Female
Humans
Male
Patient Reported Outcome Measures
Prospective Studies
Quality of Life
Retrospective Studies
Time Factors
Treatment Outcome